By Linda Logan
The New York Times
Originally published on April 26, 2013
The last time I saw my old self, I was 27 years old and living in Boston. I was doing well in graduate school, had a tight circle of friends and was a prolific creative writer. Married to my high-school sweetheart, I had just had my first child. Back then, my best times were twirling my baby girl under the gloaming sky on a Florida beach and flopping on the bed with my husband — feet propped against the wall — and talking. The future seemed wide open.
I don’t think there is a particular point at which I can say I became depressed. My illness was insidious, gradual and inexorable. I had a preview of depression in high school, when I spent a couple of years wearing all black, rimming my eyes in kohl and sliding against the walls in the hallways, hoping that no one would notice me. But back then I didn’t think it was a very serious problem.
The hormonal chaos of having three children in five years, the pressure of working on a Ph.D. dissertation and a genetic predisposition for a mood disorder took me to a place of darkness I hadn’t experienced before. Of course, I didn’t recognize that right away. Denial is a gauze; willful denial, an opiate. Everyone seemed in league with my delusion. I was just overwhelmed, my family would say. I should get more help with the kids, put off my Ph.D.
The entire story is here.
Sunday, May 5, 2013
Suicide Rate Rises Among Middle-Aged In The U.S., CDC Reports
By Mike Stobbe
The Associated Press
Published May 2, 2013
The suicide rate among middle-aged Americans climbed a startling 28 percent in a decade, a period that included the recession and the mortgage crisis, the government reported Thursday.
The trend was most pronounced among white men and women in that age group. Their suicide rate jumped 40 percent between 1999 and 2010.
But the rates in younger and older people held steady. And there was little change among middle-aged blacks, Hispanics and most other racial and ethnic groups, the report from the Centers for Disease Control and Prevention found.
Why did so many middle-aged whites – that is, those who are 35 to 64 years old – take their own lives?
One theory suggests the recession caused more emotional trauma in whites, who tend not to have the same kind of church support and extended families that blacks and Hispanics do.
The economy was in recession from the end of 2007 until mid-2009. Even well afterward, polls showed most Americans remained worried about weak hiring, a depressed housing market and other problems.
Pat Smith, violence-prevention program coordinator for the Michigan Department of Community Health, said the recession – which hit manufacturing-heavy states particularly hard – may have pushed already-troubled people over the brink. Being unable to find a job or settling for one with lower pay or prestige could add "that final weight to a whole chain of events," she said.
The entire story is here.
The Associated Press
Published May 2, 2013
The suicide rate among middle-aged Americans climbed a startling 28 percent in a decade, a period that included the recession and the mortgage crisis, the government reported Thursday.
The trend was most pronounced among white men and women in that age group. Their suicide rate jumped 40 percent between 1999 and 2010.
But the rates in younger and older people held steady. And there was little change among middle-aged blacks, Hispanics and most other racial and ethnic groups, the report from the Centers for Disease Control and Prevention found.
Why did so many middle-aged whites – that is, those who are 35 to 64 years old – take their own lives?
One theory suggests the recession caused more emotional trauma in whites, who tend not to have the same kind of church support and extended families that blacks and Hispanics do.
The economy was in recession from the end of 2007 until mid-2009. Even well afterward, polls showed most Americans remained worried about weak hiring, a depressed housing market and other problems.
Pat Smith, violence-prevention program coordinator for the Michigan Department of Community Health, said the recession – which hit manufacturing-heavy states particularly hard – may have pushed already-troubled people over the brink. Being unable to find a job or settling for one with lower pay or prestige could add "that final weight to a whole chain of events," she said.
The entire story is here.
Saturday, May 4, 2013
The Straight Path
A Conversation with Ronald A. Howard
Sam Harris Blog
Originally posted April 20, 2013
Here are some excerpts:
As I wrote in the introduction to Lying, Ronald A. Howard was one of my favorite professors in college, and his courses on ethics, social systems, and decision making did much to shape my views on these topics. Last week, he was kind enough to speak with me at length about the ethics of lying. The following post is an edited transcript of our conversation.
Ronald A. Howard directs teaching and research in the Decision Analysis Program of the Department of Management Science and Engineering at Stanford University. He is also the Director of the Department’s Decisions and Ethics Center, which examines the efficacy and ethics of social arrangements. He defined the profession of decision analysis in 1964 and has since supervised several doctoral theses in decision analysis every year. His experience includes dozens of decision analysis projects that range over virtually all fields of application, from investment planning to research strategy, and from hurricane seeding to nuclear waste isolation. He was a founding Director and Chairman of Strategic Decisions Group and is President of the Decision Education Foundation, an organization dedicated to bringing decision skills to youth. He is a member of the National Academy of Engineering, a Fellow of INFORMS and IEEE, and the 1986 Ramsey medalist of the Decision Analysis Society. He is the author, with Clint Korver, of Ethics for the Real World: Creating a Personal Code to Guide Decisions in Work and Life.
(cut)
Harris: Let’s return to the case in which you are in the presence of someone who seems likely to act unethically. Can you say more about honesty in those situations?
Howard: Well, I’d make a distinction between the maxim-breakers—in other words, a person who is harming others or stealing—and those who are merely lying or otherwise speaking unethically. Lying is not a crime unless it’s part of a fraud. If someone asks for directions to Wal-Mart, and you know the way but you send them walking in the opposite direction—it’s not a nice thing to do, but it’s not a crime. Imagine if they came back with a policeman and said, “That’s the man who misdirected me.” You could say, “Yeah, I did. It just so happens that I like to watch people wandering in the wrong direction.” That’s not a crime. It’s not nice behavior. It might be reason for someone to boycott your business, or to exclude you from certain groups, but it’s not going to land you in jail.
I make a careful distinction between what I call “maxim violations”—interfering with peaceful, honest people—and everything else.
Harris: Yes, I see. It breaks ethics into two different categories—one of which gets promoted to the legal system to protect people from various harms.
Howard: In fact, there are also two categories in the domain of lying. The first is where people acknowledge the problem—people obviously get hurt by lies—and then the other cases where more or less everyone tends to lie and feels good about it, or sees no alternative to it. That’s why your book is so important—because people think it’s a good thing to tell so-called “white” lies. Saying “Oh, you look terrific in that dress,” even when you believe it is unattractive, is a “white” lie justified by not hurting the person’s feelings.
The example that came up in class yesterday was, do you want that mirror-mirror-on-the-wall-who’s-the-fairest-of-them-all device, or do you want a mirror that shows you what you really look like? Or imagine buying a car that came with a special option that gave you information that you might prefer to the truth: When you wanted to go fast, it would indicate that you were going even faster than you were. When you passed a gas station, it would tell you that you didn’t need any gas. Of course, nobody wants that. Well, then, why would you want it in your life in general?
The entire article is here.
Sam Harris Blog
Originally posted April 20, 2013
Here are some excerpts:
As I wrote in the introduction to Lying, Ronald A. Howard was one of my favorite professors in college, and his courses on ethics, social systems, and decision making did much to shape my views on these topics. Last week, he was kind enough to speak with me at length about the ethics of lying. The following post is an edited transcript of our conversation.
Ronald A. Howard directs teaching and research in the Decision Analysis Program of the Department of Management Science and Engineering at Stanford University. He is also the Director of the Department’s Decisions and Ethics Center, which examines the efficacy and ethics of social arrangements. He defined the profession of decision analysis in 1964 and has since supervised several doctoral theses in decision analysis every year. His experience includes dozens of decision analysis projects that range over virtually all fields of application, from investment planning to research strategy, and from hurricane seeding to nuclear waste isolation. He was a founding Director and Chairman of Strategic Decisions Group and is President of the Decision Education Foundation, an organization dedicated to bringing decision skills to youth. He is a member of the National Academy of Engineering, a Fellow of INFORMS and IEEE, and the 1986 Ramsey medalist of the Decision Analysis Society. He is the author, with Clint Korver, of Ethics for the Real World: Creating a Personal Code to Guide Decisions in Work and Life.
(cut)
Harris: Let’s return to the case in which you are in the presence of someone who seems likely to act unethically. Can you say more about honesty in those situations?
Howard: Well, I’d make a distinction between the maxim-breakers—in other words, a person who is harming others or stealing—and those who are merely lying or otherwise speaking unethically. Lying is not a crime unless it’s part of a fraud. If someone asks for directions to Wal-Mart, and you know the way but you send them walking in the opposite direction—it’s not a nice thing to do, but it’s not a crime. Imagine if they came back with a policeman and said, “That’s the man who misdirected me.” You could say, “Yeah, I did. It just so happens that I like to watch people wandering in the wrong direction.” That’s not a crime. It’s not nice behavior. It might be reason for someone to boycott your business, or to exclude you from certain groups, but it’s not going to land you in jail.
I make a careful distinction between what I call “maxim violations”—interfering with peaceful, honest people—and everything else.
Harris: Yes, I see. It breaks ethics into two different categories—one of which gets promoted to the legal system to protect people from various harms.
Howard: In fact, there are also two categories in the domain of lying. The first is where people acknowledge the problem—people obviously get hurt by lies—and then the other cases where more or less everyone tends to lie and feels good about it, or sees no alternative to it. That’s why your book is so important—because people think it’s a good thing to tell so-called “white” lies. Saying “Oh, you look terrific in that dress,” even when you believe it is unattractive, is a “white” lie justified by not hurting the person’s feelings.
The example that came up in class yesterday was, do you want that mirror-mirror-on-the-wall-who’s-the-fairest-of-them-all device, or do you want a mirror that shows you what you really look like? Or imagine buying a car that came with a special option that gave you information that you might prefer to the truth: When you wanted to go fast, it would indicate that you were going even faster than you were. When you passed a gas station, it would tell you that you didn’t need any gas. Of course, nobody wants that. Well, then, why would you want it in your life in general?
The entire article is here.
Friday, May 3, 2013
Transforming Diagnosis
By Thomas Insel on April 29, 2013
NIMH Director’s Blog
In a few weeks, the American Psychiatric Association will release its new edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). This volume will tweak several current diagnostic categories, from autism spectrum disorders to mood disorders. While many of these changes have been contentious, the final product involves mostly modest alterations of the previous edition, based on new insights emerging from research since 1990 when DSM-IV was published. Sometimes this research recommended new categories (e.g., mood dysregulation disorder) or that previous categories could be dropped (e.g., Asperger’s syndrome).
The goal of this new manual, as with all previous editions, is to provide a common language for describing psychopathology. While DSM has been described as a “Bible” for the field, it is, at best, a dictionary, creating a set of labels and defining each. The strength of each of the editions of DSM has been “reliability” – each edition has ensured that clinicians use the same terms in the same ways. The weakness is its lack of validity. Unlike our definitions of ischemic heart disease, lymphoma, or AIDS, the DSM diagnoses are based on a consensus about clusters of clinical symptoms, not any objective laboratory measure. In the rest of medicine, this would be equivalent to creating diagnostic systems based on the nature of chest pain or the quality of fever. Indeed, symptom-based diagnosis, once common in other areas of medicine, has been largely replaced in the past half century as we have understood that symptoms alone rarely indicate the best choice of treatment.
Patients with mental disorders deserve better. NIMH has launched the Research Domain Criteria (RDoC) project to transform diagnosis by incorporating genetics, imaging, cognitive science, and other levels of information to lay the foundation for a new classification system.
(cut)
That is why NIMH will be re-orienting its research away from DSM categories. Going forward, we will be supporting research projects that look across current categories – or sub-divide current categories – to begin to develop a better system.
The entire blog post is here.
Editorial note: The NIMH will no longer use DSM-5 diagnostic criteria. There have also been numerous criticisms related to DSM-5. And, given that HIPAA requires ICD diagnostic codes for billing, is there a reason for psychologists to purchase a DSM-5?
NIMH Director’s Blog
In a few weeks, the American Psychiatric Association will release its new edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). This volume will tweak several current diagnostic categories, from autism spectrum disorders to mood disorders. While many of these changes have been contentious, the final product involves mostly modest alterations of the previous edition, based on new insights emerging from research since 1990 when DSM-IV was published. Sometimes this research recommended new categories (e.g., mood dysregulation disorder) or that previous categories could be dropped (e.g., Asperger’s syndrome).
The goal of this new manual, as with all previous editions, is to provide a common language for describing psychopathology. While DSM has been described as a “Bible” for the field, it is, at best, a dictionary, creating a set of labels and defining each. The strength of each of the editions of DSM has been “reliability” – each edition has ensured that clinicians use the same terms in the same ways. The weakness is its lack of validity. Unlike our definitions of ischemic heart disease, lymphoma, or AIDS, the DSM diagnoses are based on a consensus about clusters of clinical symptoms, not any objective laboratory measure. In the rest of medicine, this would be equivalent to creating diagnostic systems based on the nature of chest pain or the quality of fever. Indeed, symptom-based diagnosis, once common in other areas of medicine, has been largely replaced in the past half century as we have understood that symptoms alone rarely indicate the best choice of treatment.
Patients with mental disorders deserve better. NIMH has launched the Research Domain Criteria (RDoC) project to transform diagnosis by incorporating genetics, imaging, cognitive science, and other levels of information to lay the foundation for a new classification system.
(cut)
That is why NIMH will be re-orienting its research away from DSM categories. Going forward, we will be supporting research projects that look across current categories – or sub-divide current categories – to begin to develop a better system.
The entire blog post is here.
Editorial note: The NIMH will no longer use DSM-5 diagnostic criteria. There have also been numerous criticisms related to DSM-5. And, given that HIPAA requires ICD diagnostic codes for billing, is there a reason for psychologists to purchase a DSM-5?
Ethical and practical implications of financial conflicts of interest in the DSM-5
By Lisa Cosgrove and Emily Wheeler
doi: 10.1177/0959353512467972
Feminism Psychology
February 2013 vol. 23 no. 1 93-106
Abstract
The revision of the Diagnostic and Statistical Manual of Mental Disorders (DSM), scheduled for publication in May 2013 by the American Psychiatric Association (APA), has created a firestorm of controversy because of questions about undue industry influence. Specifically, concerns have been raised about financial conflicts of interest between DSM-5 panel members and the pharmaceutical industry. The authors argue that current approaches to the management of these relationships, particularly transparency of them, are insufficient solutions to the problem of industry’s capture of organized psychiatry. The conceptual framework of institutional corruption is used to understand psychiatry’s dependence on the pharmaceutical industry and to identify the epistemic assumptions that ground the DSM’s biopsychiatric discourse. APA’s rationale for including premenstrual dysphoric disorder in the DSM-5 as a Mood Disorder is reviewed and discussed.
Thanks to Ken Pope for sharing this abstract.
doi: 10.1177/0959353512467972
Feminism Psychology
February 2013 vol. 23 no. 1 93-106
Abstract
The revision of the Diagnostic and Statistical Manual of Mental Disorders (DSM), scheduled for publication in May 2013 by the American Psychiatric Association (APA), has created a firestorm of controversy because of questions about undue industry influence. Specifically, concerns have been raised about financial conflicts of interest between DSM-5 panel members and the pharmaceutical industry. The authors argue that current approaches to the management of these relationships, particularly transparency of them, are insufficient solutions to the problem of industry’s capture of organized psychiatry. The conceptual framework of institutional corruption is used to understand psychiatry’s dependence on the pharmaceutical industry and to identify the epistemic assumptions that ground the DSM’s biopsychiatric discourse. APA’s rationale for including premenstrual dysphoric disorder in the DSM-5 as a Mood Disorder is reviewed and discussed.
Thanks to Ken Pope for sharing this abstract.
Thursday, May 2, 2013
Psychiatrists waste 1 million hours getting patients admitted
United Press International
Originally published April 24, 2013
U.S. psychiatrists spend an average 38 minutes telephoning an insurance company getting authorization to admit a patient to the hospital, researchers say.
Lead author Dr. Amy Funkenstein, a child psychiatry fellow at Brown University in Providence, R.I., led the study while she was a psychiatric resident at Cambridge Health Alliance and Harvard Medical School in Boston.
Over a three-month period, the researchers tabulated how long psychiatric patients who were deemed in need of inpatient admission stayed in the emergency department prior to being hospitalized, and the amount of time the ED psychiatrists spent obtaining authorization from the patient's insurer.
Most psychiatric patients required hospitalization because they were suicidal or, in a few cases, homicidal, Funkenstein said.
The entire story is here.
Originally published April 24, 2013
U.S. psychiatrists spend an average 38 minutes telephoning an insurance company getting authorization to admit a patient to the hospital, researchers say.
Lead author Dr. Amy Funkenstein, a child psychiatry fellow at Brown University in Providence, R.I., led the study while she was a psychiatric resident at Cambridge Health Alliance and Harvard Medical School in Boston.
Over a three-month period, the researchers tabulated how long psychiatric patients who were deemed in need of inpatient admission stayed in the emergency department prior to being hospitalized, and the amount of time the ED psychiatrists spent obtaining authorization from the patient's insurer.
Most psychiatric patients required hospitalization because they were suicidal or, in a few cases, homicidal, Funkenstein said.
The entire story is here.
The Role of Medical Professionals Related to Hunger Strikes at Guantanamo
Obama to Seek Closing Amid Hunger Strikes at Guantanamo
By Charlie Savage
The New York Times
Originally published April 30, 2013
Here is a piece of the article:
Last week, the president of the American Medical Association, Dr. Jeremy A. Lazarus, wrote a letter to Defense Secretary Chuck Hagel saying that any doctor who participated in forcing a prisoner to eat against his will was violating “core ethical values of the medical profession.”
“Every competent patient has the right to refuse medical intervention, including life-sustaining interventions,” Dr. Lazarus wrote.
He also noted that the A.M.A. endorses the World Medical Association’s Tokyo Declaration, a 1975 statement forbidding doctors to use their medical knowledge to facilitate torture. It says that if a prisoner makes “an unimpaired and rational judgment” to refuse nourishment, “he or she shall not be fed artificially.”
The military’s policy, however, is that it can and should preserve the life of a detainee by forcing him to eat if necessary.
“In the case of a hunger strike, attempted suicide or other attempted serious self-harm, medical treatment or intervention may be directed without the consent of the detainee to prevent death or serious harm,” a military policy directive says. “Such action must be based on a medical determination that immediate treatment or intervention is necessary to prevent death or serious harm and, in addition, must be approved by the commanding officer of the detention facility or other designated senior officer responsible for detainee operations.”
On Monday, Colonel House also said that some detainees on the “enteral feeding” list were drinking the supplement.
“Just because the detainees are approved for enteral feeding does not mean they don’t eat a regular meal,” he said. “Once the detainees leave their cell and are in the presence of medical personnel, most of the detainees who are approved for tube feeding will eat or drink without the peer pressure from inside the cellblock.”
Medical ethicists and the Pentagon also clashed during the Bush administration over hunger strikes at Guantánamo.
The entire article is here.
By Charlie Savage
The New York Times
Originally published April 30, 2013
Here is a piece of the article:
Last week, the president of the American Medical Association, Dr. Jeremy A. Lazarus, wrote a letter to Defense Secretary Chuck Hagel saying that any doctor who participated in forcing a prisoner to eat against his will was violating “core ethical values of the medical profession.”
“Every competent patient has the right to refuse medical intervention, including life-sustaining interventions,” Dr. Lazarus wrote.
He also noted that the A.M.A. endorses the World Medical Association’s Tokyo Declaration, a 1975 statement forbidding doctors to use their medical knowledge to facilitate torture. It says that if a prisoner makes “an unimpaired and rational judgment” to refuse nourishment, “he or she shall not be fed artificially.”
The military’s policy, however, is that it can and should preserve the life of a detainee by forcing him to eat if necessary.
“In the case of a hunger strike, attempted suicide or other attempted serious self-harm, medical treatment or intervention may be directed without the consent of the detainee to prevent death or serious harm,” a military policy directive says. “Such action must be based on a medical determination that immediate treatment or intervention is necessary to prevent death or serious harm and, in addition, must be approved by the commanding officer of the detention facility or other designated senior officer responsible for detainee operations.”
On Monday, Colonel House also said that some detainees on the “enteral feeding” list were drinking the supplement.
“Just because the detainees are approved for enteral feeding does not mean they don’t eat a regular meal,” he said. “Once the detainees leave their cell and are in the presence of medical personnel, most of the detainees who are approved for tube feeding will eat or drink without the peer pressure from inside the cellblock.”
Medical ethicists and the Pentagon also clashed during the Bush administration over hunger strikes at Guantánamo.
The entire article is here.
Wednesday, May 1, 2013
Antidotes to Burnout: Fostering Physician Resiliency, Well-Being, and Holistic Development
By Herdley O. Paolini, Burt Bertram, & Ted Hamilton
Medscape News
Originally published April 19, 2013
Florida Hospital -- an Orlando-based 8-campus hospital with 2200 beds, a 2000-plus physician medical staff, and more inpatient admissions annually than any other hospital in the United States -- is home to Physician Support Services, a pioneering program created to address physician burnout.
The program provides whole-person care through specialized professional resources aimed at maximizing the personal and professional well-being of Florida Hospital physicians and their families. The direct financial benefit of the program to Florida Hospital is in excess of $5 million over the past 2 years, and the program has rescued the careers of more than 100 physicians in the past 10 years.
The service includes confidential psychotherapy and coaching, continuing medical education (CME) with credit that is focused on helping physicians integrate their personal and professional lives, dialogue programs about cultivating meaning in medical practice, physician leadership development, and marriage retreats.
The Florida Hospital program is based on an in-depth and compassionate understanding of the forces affecting physicians and the practice of medicine, as well as the belief that physician leadership is crucial in envisioning and operationalizing the changes that are needed in the practice of medicine. Rather than ignoring, stigmatizing, or penalizing distressed physicians, Physician Support Services pragmatically addresses the emotional, spiritual, family, and performance issues associated with physician burnout, while intentionally developing physician leadership.
The entire story is here.
Medscape News
Originally published April 19, 2013
Florida Hospital -- an Orlando-based 8-campus hospital with 2200 beds, a 2000-plus physician medical staff, and more inpatient admissions annually than any other hospital in the United States -- is home to Physician Support Services, a pioneering program created to address physician burnout.
The program provides whole-person care through specialized professional resources aimed at maximizing the personal and professional well-being of Florida Hospital physicians and their families. The direct financial benefit of the program to Florida Hospital is in excess of $5 million over the past 2 years, and the program has rescued the careers of more than 100 physicians in the past 10 years.
The service includes confidential psychotherapy and coaching, continuing medical education (CME) with credit that is focused on helping physicians integrate their personal and professional lives, dialogue programs about cultivating meaning in medical practice, physician leadership development, and marriage retreats.
The Florida Hospital program is based on an in-depth and compassionate understanding of the forces affecting physicians and the practice of medicine, as well as the belief that physician leadership is crucial in envisioning and operationalizing the changes that are needed in the practice of medicine. Rather than ignoring, stigmatizing, or penalizing distressed physicians, Physician Support Services pragmatically addresses the emotional, spiritual, family, and performance issues associated with physician burnout, while intentionally developing physician leadership.
The entire story is here.
The Lies We Tell in the Exam Room
By Abigail Zuger
The New York Times - Well Column
Published April 22, 2013
Here are some excerpts:
In a recent issue of The American Journal of Bioethics, a half-dozen ethicists chewed over the question of whether a decision to play Robin Hood with the medical insurer is actually ethical. Say that the patient’s health — or even life — is at stake: The insurer, for example, is refusing to pay for an essential test or medication unless the doctor writes down a bogus diagnosis the patient does not have. The experts came down firmly and eloquently on both sides of the issue.
Nicolas Tavaglione and Dr. Samia A. Hurst, both at the Institute for Biomedical Ethics at Geneva University Medical School in Switzerland, argued that lying for a patient under such circumstances was not only ethically permissible but mandatory. Helping a patient takes precedence over all other considerations, they wrote. Telling the truth would be “honoring an ideal principle in a nonideal world.”
Other ethicists protested, pointing out that too many doctors playing Robin Hood would make insurers tighten purse strings further. Dr. Thomas S. Huddle, of the medical school at the University of Alabama, Birmingham, wrote that all lies, even those told for a good cause, imperil the moral fabric of medicine. Dr. Robert M. Sade, of the Medical University of South Carolina, feared instead for the moral fabric of the doctor, pointing out that every lie “reinforces the habit of lying,” which then becomes easier and easier until the “morally disengaged” doctor is capable of really bad behavior.
The entire article is here.
The New York Times - Well Column
Published April 22, 2013
Here are some excerpts:
In a recent issue of The American Journal of Bioethics, a half-dozen ethicists chewed over the question of whether a decision to play Robin Hood with the medical insurer is actually ethical. Say that the patient’s health — or even life — is at stake: The insurer, for example, is refusing to pay for an essential test or medication unless the doctor writes down a bogus diagnosis the patient does not have. The experts came down firmly and eloquently on both sides of the issue.
Nicolas Tavaglione and Dr. Samia A. Hurst, both at the Institute for Biomedical Ethics at Geneva University Medical School in Switzerland, argued that lying for a patient under such circumstances was not only ethically permissible but mandatory. Helping a patient takes precedence over all other considerations, they wrote. Telling the truth would be “honoring an ideal principle in a nonideal world.”
Other ethicists protested, pointing out that too many doctors playing Robin Hood would make insurers tighten purse strings further. Dr. Thomas S. Huddle, of the medical school at the University of Alabama, Birmingham, wrote that all lies, even those told for a good cause, imperil the moral fabric of medicine. Dr. Robert M. Sade, of the Medical University of South Carolina, feared instead for the moral fabric of the doctor, pointing out that every lie “reinforces the habit of lying,” which then becomes easier and easier until the “morally disengaged” doctor is capable of really bad behavior.
The entire article is here.
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