CBS/AP
Originally posted on March 21, 2013
The nation's most influential pediatrician's group has endorsed same-sex marriage, saying a stable relationship between parents regardless of sexual orientation contributes to a child's health and well-being.
The new policy of the American Academy of Pediatrics, published online Thursday, cites research showing that the parents' sexual orientation has no effect on a child's development. Kids fare just as well in same-sex or straight families when they are nurturing and financially and emotionally stable, the academy says.
Separately, a new national survey shows the nation's views on same-sex marriage are more favorable -- in large part because of a shift in attitudes among those who know someone who is gay or became more accepting as they got older of gays and lesbians.
The Pew Research Center poll also finds that a large group of younger adults who tend to be more open to gay rights is driving the numbers upward.
The entire article is here.
Sunday, March 31, 2013
Saturday, March 30, 2013
Patients should decide what the end of life is like, study says
By Mary VacVean
The Los Angeles Times
Originally published March 20, 2013
Finding out what dying patients want and treating them accordingly leads to happier patients who are in less pain and who use fewer healthcare dollars, UCLA researchers said Tuesday.
“You can improve care while reducing costs by making sure that everything you do is centered on what the patients want, what his or her specific goals are and tailor a treatment plan to ensure we provide the specific care he or she wants,” Dr. Jonathan Bergman, a Robert Wood Johnson clinical scholar at UCLA, said in a statement.
Bergman and colleagues wrote an article advocating for patient-centered care at the end of life in the journal JAMA Surgery.
People who are dying often receive care that is poorly coordinated and not in line with the patient’s values or goals, the journal authors said. That should change, they said.
The entire article is here.
The Los Angeles Times
Originally published March 20, 2013
Finding out what dying patients want and treating them accordingly leads to happier patients who are in less pain and who use fewer healthcare dollars, UCLA researchers said Tuesday.
“You can improve care while reducing costs by making sure that everything you do is centered on what the patients want, what his or her specific goals are and tailor a treatment plan to ensure we provide the specific care he or she wants,” Dr. Jonathan Bergman, a Robert Wood Johnson clinical scholar at UCLA, said in a statement.
Bergman and colleagues wrote an article advocating for patient-centered care at the end of life in the journal JAMA Surgery.
People who are dying often receive care that is poorly coordinated and not in line with the patient’s values or goals, the journal authors said. That should change, they said.
The entire article is here.
Do We Need 'Thanaticians' for the Terminally Ill?
By Ronald W. Pies
Medscape - Ethics in Psychiatry
Originally published September 26, 2012
My 89-year-old mother had been losing ground for some years, experiencing what geriatricians sometimes call "the dwindles." Toward the end of her life, she was beset by a deteriorating heart; an inability to walk; and occasional, severe gastrointestinal pain. My family got her the best medical treatment available -- eventually including home hospice care -- and she generally maintained a positive attitude throughout her long downhill slide.
But one day, as I sat beside her bed, she seemed unusually subdued. "Honey," she said, "How do I get out of this mess?" I had a pretty good idea of what she was really asking me, but I deflected her question with another question: "Ma, what 'mess' do you mean?" I asked. "It's all right," she replied, smiling sadly, "I'll manage."
My mother was doing what she had always done: sparing her children from pain. In this case, it was the pain of dealing with the waning days of her life and the frustration of knowing there was no easy escape from the burdens of dying slowly. "Ma, I'll always make sure you are getting enough treatment for your pain," I added, taking her hand -- knowing that the prospect of unremitting pain is often an underlying fear of terminally ill persons.
Yet, unspoken in my mother's question was the issue of so-called physician-assisted dying, sometimes called "physician-assisted suicide" -- an enormously heated controversy both outside and within the medical profession. In my home state, Massachusetts, the issue has come to the fore, owing to a November ballot initiative for a measure that would allow terminally ill patients to be prescribed lethal drugs. A closely related bill (H.3884) has also come before the Massachusetts Legislature's Joint Committee on the Judiciary.
The entire ethical dilemma is here.
Medscape - Ethics in Psychiatry
Originally published September 26, 2012
My 89-year-old mother had been losing ground for some years, experiencing what geriatricians sometimes call "the dwindles." Toward the end of her life, she was beset by a deteriorating heart; an inability to walk; and occasional, severe gastrointestinal pain. My family got her the best medical treatment available -- eventually including home hospice care -- and she generally maintained a positive attitude throughout her long downhill slide.
But one day, as I sat beside her bed, she seemed unusually subdued. "Honey," she said, "How do I get out of this mess?" I had a pretty good idea of what she was really asking me, but I deflected her question with another question: "Ma, what 'mess' do you mean?" I asked. "It's all right," she replied, smiling sadly, "I'll manage."
My mother was doing what she had always done: sparing her children from pain. In this case, it was the pain of dealing with the waning days of her life and the frustration of knowing there was no easy escape from the burdens of dying slowly. "Ma, I'll always make sure you are getting enough treatment for your pain," I added, taking her hand -- knowing that the prospect of unremitting pain is often an underlying fear of terminally ill persons.
Yet, unspoken in my mother's question was the issue of so-called physician-assisted dying, sometimes called "physician-assisted suicide" -- an enormously heated controversy both outside and within the medical profession. In my home state, Massachusetts, the issue has come to the fore, owing to a November ballot initiative for a measure that would allow terminally ill patients to be prescribed lethal drugs. A closely related bill (H.3884) has also come before the Massachusetts Legislature's Joint Committee on the Judiciary.
The entire ethical dilemma is here.
Friday, March 29, 2013
Kaiser Permanente cited for EHR mental health violations
By Jennifer Bresnick
EHR Intelligence
Originally published on March 20, 2013
Kaiser Permanente, the largest healthcare provider in California, has been cited by the California Department of Managed Healthcare (DMHC) for keeping two sets of patient records: an official EHR that it showed to state inspectors, and a parallel paper record that hid violations of the state’s “timely access” law that mandates shorter wait times for mental healthcare than Kaiser was able to provide. The inaccuracies involved in the HMO’s dual record keeping system meant that mental health patients may have waited weeks longer than the law stipulates for appointments, resulting in illegal denials of access to care for schizophrenia, autism, depression and suicidal ideation, among other serious conditions.
The problem stems from Kaiser’s double appointment keeping procedures. While there is an electronic version – the version that gets reported to government officials – Kaiser also used paper lists in some facilities, rendering its electronic appointment wait time calculators useless.
The entire story is here.
Thanks to Ed Zuckerman for this story.
EHR Intelligence
Originally published on March 20, 2013
Kaiser Permanente, the largest healthcare provider in California, has been cited by the California Department of Managed Healthcare (DMHC) for keeping two sets of patient records: an official EHR that it showed to state inspectors, and a parallel paper record that hid violations of the state’s “timely access” law that mandates shorter wait times for mental healthcare than Kaiser was able to provide. The inaccuracies involved in the HMO’s dual record keeping system meant that mental health patients may have waited weeks longer than the law stipulates for appointments, resulting in illegal denials of access to care for schizophrenia, autism, depression and suicidal ideation, among other serious conditions.
The problem stems from Kaiser’s double appointment keeping procedures. While there is an electronic version – the version that gets reported to government officials – Kaiser also used paper lists in some facilities, rendering its electronic appointment wait time calculators useless.
The entire story is here.
Thanks to Ed Zuckerman for this story.
Proof That Obamacare 'Rate Shock' Is An Ugly Insurance Company Deception
By Rick Unger
Forbes - Op Ed
Originally published on March 26, 2013
Over the past few months, the nation’s largest health insurance companies have been hard at work selling a narrative claiming that the Affordable Care Act is about to result in dramatically larger premium costs for a significant number of Americans. Indeed, the warnings have become so worrisome that the massive increases they are predicting have taken on a frightening descriptor all its own—rate shock.
At the heart of the health insurers’ retelling of the Chicken Little story is a regulation promulgated by the Department of Health and Human Services a few months back limiting what a health insurer can charge a 64 year old to three times what they charge a 21 year old. Currently, the average bump for older participants is typically five times that of the younger customers—although there are examples where the increase can reach ten times what is paid by the young immortals buying coverage.
As a result of the lower premium prices that will be paid by older participant, the expectation—one created by the large insurance companies—is that the youngest participants will have to pay significantly more to make up the difference.
Now, The Urban Institute—an organization so clearly bi-partisan that even the most suspicious partisan would encounter extreme difficulty making a case for bias—is out with a study that states that the ‘rate shock’ argument is “unfounded”, particularly when applied to the millions of Americans in the individual market.
The entire Op Ed is here.
The study debunking the "rate shock" rumor is here.
Forbes - Op Ed
Originally published on March 26, 2013
Over the past few months, the nation’s largest health insurance companies have been hard at work selling a narrative claiming that the Affordable Care Act is about to result in dramatically larger premium costs for a significant number of Americans. Indeed, the warnings have become so worrisome that the massive increases they are predicting have taken on a frightening descriptor all its own—rate shock.
At the heart of the health insurers’ retelling of the Chicken Little story is a regulation promulgated by the Department of Health and Human Services a few months back limiting what a health insurer can charge a 64 year old to three times what they charge a 21 year old. Currently, the average bump for older participants is typically five times that of the younger customers—although there are examples where the increase can reach ten times what is paid by the young immortals buying coverage.
As a result of the lower premium prices that will be paid by older participant, the expectation—one created by the large insurance companies—is that the youngest participants will have to pay significantly more to make up the difference.
Now, The Urban Institute—an organization so clearly bi-partisan that even the most suspicious partisan would encounter extreme difficulty making a case for bias—is out with a study that states that the ‘rate shock’ argument is “unfounded”, particularly when applied to the millions of Americans in the individual market.
The entire Op Ed is here.
The study debunking the "rate shock" rumor is here.
Thursday, March 28, 2013
Bringing a Virtual Brain to Life
By Tim Requarth
The New York Times
Originally published March 18, 2013
Here are some excerpts:
In 2009, Dr. Markram conceived of the Human Brain Project, a sprawling and controversial initiative of more than 150 institutions around the world that he hopes will bring scientists together to realize his dream.
The New York Times
Originally published March 18, 2013
Here are some excerpts:
In 2009, Dr. Markram conceived of the Human Brain Project, a sprawling and controversial initiative of more than 150 institutions around the world that he hopes will bring scientists together to realize his dream.
In January, the European Union raised the stakes by awarding the project a 10-year grant of up to $1.3 billion — an unheard-of sum in neuroscience.
“A meticulous virtual copy of the human brain,” Dr. Markram wrote in Scientific American, “would enable basic research on brain cells and circuits or computer-based drug trials.”
An equally ambitious “big brain” idea is in the works in the United States: The Obama administration is expected to propose its own project, with up to $3 billion allocated over a decade to develop technologies to track the electrical activity of every neuron in the brain.
But just as many obstacles stand in the way of the American project, a number of scientists have expressed serious reservations about Dr. Markram’s project.
Some say we don’t know enough about the brain to simulate it on a supercomputer. And even if we did, these critics ask, what would be the value of building such a complicated “virtual brain”?
(cut)
“It’s not like the Human Genome Project, where you just have to read out a few billion base pairs and you’re done,” said Peter Dayan, a neuroscientist at University College London. “For the human brain, what would you need to know to build a simulation? That’s a huge research question, and it has to do with what’s important to know about the brain.”
And Haim Sompolinsky, a neuroscientist at the Hebrew University of Jerusalem, said: “The rhetoric is that in a decade they will be able to reverse-engineer the human brain in computers. This is fantasy. Nothing will come close to it in a decade.”
New Guidelines Raise Safety Bar on Concussions
By Alan Mozes
Medicinenet.com
Originally published March 18, 2013
Any athlete who suffers a suspected concussion should be withdrawn from play and stay on the sidelines until a qualified health care professional determines that all symptoms have subsided and it is safe to return to the field, new guidelines state.
Issued by the American Academy of Neurology, the latest recommendations aim to keep young athletes as safe as possible.
"With the older guidelines, we were trying to rate concussions at the time of the injury and predict recovery times, but now we know, 'When in doubt, sit 'em out,'" said guideline co-author Dr. Christopher Giza, an associate professor of pediatric neurology and neurosurgery with the David Geffen School of Medicine at the University of California, Los Angeles, and Mattel Children's Hospital.
"The point is that no single quick test is really a litmus test for a concussion," he said. "We know now that we need to make sure a player has had a thorough and proper evaluation, involving a symptoms checklist, a standardized assessment and balance and cognitive testing, before being returned to play. This evaluation has to be done on a case-by-case basis, so each person goes through an individualized recovery process."
Medicinenet.com
Originally published March 18, 2013
Any athlete who suffers a suspected concussion should be withdrawn from play and stay on the sidelines until a qualified health care professional determines that all symptoms have subsided and it is safe to return to the field, new guidelines state.
Issued by the American Academy of Neurology, the latest recommendations aim to keep young athletes as safe as possible.
"With the older guidelines, we were trying to rate concussions at the time of the injury and predict recovery times, but now we know, 'When in doubt, sit 'em out,'" said guideline co-author Dr. Christopher Giza, an associate professor of pediatric neurology and neurosurgery with the David Geffen School of Medicine at the University of California, Los Angeles, and Mattel Children's Hospital.
"The point is that no single quick test is really a litmus test for a concussion," he said. "We know now that we need to make sure a player has had a thorough and proper evaluation, involving a symptoms checklist, a standardized assessment and balance and cognitive testing, before being returned to play. This evaluation has to be done on a case-by-case basis, so each person goes through an individualized recovery process."
Wednesday, March 27, 2013
How Does Technology Affect Business Ethics?
By Hans Fredrick
azcentral.com
The more integrated a piece of technology becomes into the way we do business, the more the potential ethical conundrums posed by that technology become apparent. Ethical business practices need to grow and evolve in step with technology. While new devices and advances may make the day-to-day operations of running a business easier, they also create challenges that the ethical businessperson must contend with.
Privacy
Privacy has become a much larger concern in the modern technological age. Business ethicists are still learning and debating how much privacy people are entitled to in the digital age, as are lawmakers. For instance, many employers had taken to the practice of requiring potential employees to provide them with the password to their Facebook pages. This opened up the door to potential privacy issues, not to mention discriminatory hiring practices. In 2012, a law was passed in California to prohibit this particular breach of privacy; but in some jurisdictions, the decision whether or not to ask for this information is still an ethical, rather than a legal matter.
The entire story is here.
azcentral.com
The more integrated a piece of technology becomes into the way we do business, the more the potential ethical conundrums posed by that technology become apparent. Ethical business practices need to grow and evolve in step with technology. While new devices and advances may make the day-to-day operations of running a business easier, they also create challenges that the ethical businessperson must contend with.
Privacy
Privacy has become a much larger concern in the modern technological age. Business ethicists are still learning and debating how much privacy people are entitled to in the digital age, as are lawmakers. For instance, many employers had taken to the practice of requiring potential employees to provide them with the password to their Facebook pages. This opened up the door to potential privacy issues, not to mention discriminatory hiring practices. In 2012, a law was passed in California to prohibit this particular breach of privacy; but in some jurisdictions, the decision whether or not to ask for this information is still an ethical, rather than a legal matter.
The entire story is here.
Drones, Ethics and the Armchair Soldier
By John Kaag
The New York Times - Opinionator
Originally published on March 17, 2013
Here are some excerpts:
Ten years later, I’m a philosopher writing a book about the ethics of drone warfare. Some days I fear that I will have either to give up the book or to give up philosophy. I worry that I can’t have both. Some of my colleagues would like me to provide decision procedures for military planners and soldiers, the type that could guide them, automatically, unthinkingly, mechanically, to the right decision about drone use. I try to tell them that this is not how ethics, or philosophy, or humans, work.
I try to tell them that the difference between humans and robots is precisely the ability to think and reflect, in Immanuel Kant’s words, to set and pursue ends for themselves. And these ends cannot be set beforehand in some hard and fast way — even if Kant sometimes thought they could.
What disturbs me is the idea that a book about the moral hazard of military technologies should be written as if it was going to be read by robots: input decision procedure, output decision and correlated action. I know that effective military operations have traditionally been based on the chain of command and that this looks a little like the command and control structure of robots. When someone is shooting at you, I can only imagine that you need to follow orders mechanically. The heat of battle is neither the time nor the place for cool ethical reflection.
Warfare, unlike philosophy, could never be conducted from an armchair. Until now. For the first time in history, some soldiers have this in common with philosophers: they can do their jobs sitting down. They now have what I’ve always enjoyed, namely “leisure,” in the Hobbesian sense of the word, meaning they are not constantly afraid of being killed. Hobbes thought that there are certain not-so-obvious perks to leisure (not being killed is the obvious one). For one, you get to think. This is what he means when he says that “leisure is the mother of philosophy.” I tend to agree with Hobbes: only those who enjoy a certain amount of leisure can be philosophers.
The entire article is here.
The New York Times - Opinionator
Originally published on March 17, 2013
Here are some excerpts:
Ten years later, I’m a philosopher writing a book about the ethics of drone warfare. Some days I fear that I will have either to give up the book or to give up philosophy. I worry that I can’t have both. Some of my colleagues would like me to provide decision procedures for military planners and soldiers, the type that could guide them, automatically, unthinkingly, mechanically, to the right decision about drone use. I try to tell them that this is not how ethics, or philosophy, or humans, work.
I try to tell them that the difference between humans and robots is precisely the ability to think and reflect, in Immanuel Kant’s words, to set and pursue ends for themselves. And these ends cannot be set beforehand in some hard and fast way — even if Kant sometimes thought they could.
What disturbs me is the idea that a book about the moral hazard of military technologies should be written as if it was going to be read by robots: input decision procedure, output decision and correlated action. I know that effective military operations have traditionally been based on the chain of command and that this looks a little like the command and control structure of robots. When someone is shooting at you, I can only imagine that you need to follow orders mechanically. The heat of battle is neither the time nor the place for cool ethical reflection.
Warfare, unlike philosophy, could never be conducted from an armchair. Until now. For the first time in history, some soldiers have this in common with philosophers: they can do their jobs sitting down. They now have what I’ve always enjoyed, namely “leisure,” in the Hobbesian sense of the word, meaning they are not constantly afraid of being killed. Hobbes thought that there are certain not-so-obvious perks to leisure (not being killed is the obvious one). For one, you get to think. This is what he means when he says that “leisure is the mother of philosophy.” I tend to agree with Hobbes: only those who enjoy a certain amount of leisure can be philosophers.
The entire article is here.
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