By Lisa Gillespie
The Washington Post
Originally published January 5, 2015
Even though more Americans than before have access to health insurance because of the Affordable Care Act, getting mental health services can still be challenging.
A report released in November concludes that despite a 2008 mental health parity law, some state exchange health plans may have a way to go to even the playing field between mental and physical benefits. The report, released by the advocacy group Mental Health America, was paid for by Takeda Pharmaceuticals U.S.A. and Lundbeck U.S.A., a pharmaceutical company that specializes in neurology and psychiatric treatments.
The report listed the states with the lowest prevalence of mental illness and the highest rates of access to care as Massachusetts, Vermont, Maine, North Dakota and Delaware. Those with the highest prevalence of mental illness and most limited access are Arizona, Mississippi, Nevada, Washington and Louisiana.
The entire article is here.
Wednesday, January 21, 2015
Laws that Conflict with the Ethics of Medicine: What Should Doctors Do?
By Dena S. Davis and Eric Kodish
Hastings Center Report 44, no. 6 (2014): 11-14.
DOI: 10.1002/hast.382
Here is an excerpt:
Medical ethics has always asked doctors to put their patients first, even at some risk to themselves. “Medicine is, at its center, a moral enterprise grounded in a covenant of trust,” writes Christine Cassell. “This covenant obliges physicians to be competent and to use their competence in the patient's best interests. Physicians, therefore, are both intellectually and morally obliged to act as advocates for the sick wherever their welfare is threatened and for their health at all times.”[19] Physicians are expected to care for patients with infectious diseases, even at risk of their own health. Physicians are expected to do some pro bono work, to take on some patients who are not financial assets, and so on. Physicians should be advocates for the health of all people, above and beyond even their own patients. The AAP is “dedicated to the health of all children.”[20] The imperative to act on this ethical norm clearly suggests that physicians should challenge these types of laws. On rare occasions, individual doctors may be ethically justified in disobeying or breaking the law.
The entire article is here.
Hastings Center Report 44, no. 6 (2014): 11-14.
DOI: 10.1002/hast.382
Here is an excerpt:
Medical ethics has always asked doctors to put their patients first, even at some risk to themselves. “Medicine is, at its center, a moral enterprise grounded in a covenant of trust,” writes Christine Cassell. “This covenant obliges physicians to be competent and to use their competence in the patient's best interests. Physicians, therefore, are both intellectually and morally obliged to act as advocates for the sick wherever their welfare is threatened and for their health at all times.”[19] Physicians are expected to care for patients with infectious diseases, even at risk of their own health. Physicians are expected to do some pro bono work, to take on some patients who are not financial assets, and so on. Physicians should be advocates for the health of all people, above and beyond even their own patients. The AAP is “dedicated to the health of all children.”[20] The imperative to act on this ethical norm clearly suggests that physicians should challenge these types of laws. On rare occasions, individual doctors may be ethically justified in disobeying or breaking the law.
The entire article is here.
Tuesday, January 20, 2015
Bioethics: why philosophy is essential for progress
By Julian Savulescu
J Med Ethics 2015;41:28-33 doi:10.1136/medethics-2014-102284
Here is an excerpt:
Ethics is concerned with norms and values. Its subject matter is the way the world ought to be or should be. It is about good and bad, right and wrong. Science is about the way the world is, was, will be, could be, would be. Ethics is about values; science is about facts. (Strictly, science is about natural facts. On realist views of ethics, ethics is about normative or evaluative facts.)
David Hume famously described this ‘fact–value’ or ‘is–ought’ distinction. One of his greatest contributions to ethics was to observe that values cannot be read straight off natural facts. To do so is what GE Moore described as the naturalistic fallacy. Science and ethics are completely different kinds of enterprises.
This distinction is essential to understanding the failure of much of bioethics and medical ethics. Even if science were complete and we knew everything about the world and ourselves, it would not answer the ethical questions of how we should live or whether equality is more important than maximising the good, or when we should die. The stated basis of the National Health Service is egalitarianism—equal treatment for equal need. But that is a highly contestable ethical principle.
The entire article is here.
J Med Ethics 2015;41:28-33 doi:10.1136/medethics-2014-102284
Here is an excerpt:
Ethics is concerned with norms and values. Its subject matter is the way the world ought to be or should be. It is about good and bad, right and wrong. Science is about the way the world is, was, will be, could be, would be. Ethics is about values; science is about facts. (Strictly, science is about natural facts. On realist views of ethics, ethics is about normative or evaluative facts.)
David Hume famously described this ‘fact–value’ or ‘is–ought’ distinction. One of his greatest contributions to ethics was to observe that values cannot be read straight off natural facts. To do so is what GE Moore described as the naturalistic fallacy. Science and ethics are completely different kinds of enterprises.
This distinction is essential to understanding the failure of much of bioethics and medical ethics. Even if science were complete and we knew everything about the world and ourselves, it would not answer the ethical questions of how we should live or whether equality is more important than maximising the good, or when we should die. The stated basis of the National Health Service is egalitarianism—equal treatment for equal need. But that is a highly contestable ethical principle.
The entire article is here.
Dilemma over deductibles: Costs crippling middle class
By Laura Ungarand Jayne O'Donnell
The Battle Creek Enquirer
Originally published January 2, 2015
Here are two excerpts:
A recent Commonwealth Fund survey found that four in 10 working-age adults skipped some kind of care because of cost. The portion of workers with annual deductibles — what consumers must pay before insurance kicks in — rose from 55% eight years ago to 80% today, according to research by the Kaiser Family Foundation.
A Mercer study showed that 2014 saw the largest one-year increase in enrollment in “high-deductible plans” — from 18% to 23% of all covered employees.
(cut)
Doctors and doctor groups say such individual coping strategies can be helpful, but action is needed on a national level. The American Academy of Pediatrics recently came out with a policy statement saying high-deductible plans “may be a less desirable way to lower health care costs than other means … even if ‘other means’ require more work by government, insurance companies and other health policy participants.”
The entire story is here.
The Battle Creek Enquirer
Originally published January 2, 2015
Here are two excerpts:
A recent Commonwealth Fund survey found that four in 10 working-age adults skipped some kind of care because of cost. The portion of workers with annual deductibles — what consumers must pay before insurance kicks in — rose from 55% eight years ago to 80% today, according to research by the Kaiser Family Foundation.
A Mercer study showed that 2014 saw the largest one-year increase in enrollment in “high-deductible plans” — from 18% to 23% of all covered employees.
(cut)
Doctors and doctor groups say such individual coping strategies can be helpful, but action is needed on a national level. The American Academy of Pediatrics recently came out with a policy statement saying high-deductible plans “may be a less desirable way to lower health care costs than other means … even if ‘other means’ require more work by government, insurance companies and other health policy participants.”
The entire story is here.
Monday, January 19, 2015
Belgian rapist Frank Van Den Bleeken 'to be euthanised' in prison this week
By Roisin O'Connor
The Independent
Originally posted January 5, 2015
A convicted murderer and rapist who won the right to end his life rather than endure 'unbearable suffering' in prison will be euthanised on 11 January.
Granted the right to die under Belgium’s liberal euthanasia laws in September, Frank Van Den Bleeken claimed he could not face the rest of his life in jail and argued that he would never be able to overcome his violent sexual impulses.
The entire article is here.
The Independent
Originally posted January 5, 2015
A convicted murderer and rapist who won the right to end his life rather than endure 'unbearable suffering' in prison will be euthanised on 11 January.
Granted the right to die under Belgium’s liberal euthanasia laws in September, Frank Van Den Bleeken claimed he could not face the rest of his life in jail and argued that he would never be able to overcome his violent sexual impulses.
The entire article is here.
Early Death for Severe Mental Illness?
By Allen Frances
The Huffington Post Blog
Originally published December 30, 2014
People diagnosed with serious mental illness -- schizophrenia, bipolar disorder, or severe depression -- die 20 years early, on average, because of a combination of lousy medical care, smoking, lack of exercise, complications of medication, suicide, and accidents. They are the most discriminated-against and neglected group in the U.S., which has become probably the worst place in the developed world to be mentally ill.
In many previous blog posts I have bemoaned the shameful state of psychiatric care and housing for people with severe mental illness. My conclusion was that the United States has become the worst place, and now the worst time ever, to have a severe mental illness. Hundreds of thousands of the severely ill languish inappropriately in prisons. Additional hundreds of thousands are homeless on the street.
The entire blog post is here.
The Huffington Post Blog
Originally published December 30, 2014
People diagnosed with serious mental illness -- schizophrenia, bipolar disorder, or severe depression -- die 20 years early, on average, because of a combination of lousy medical care, smoking, lack of exercise, complications of medication, suicide, and accidents. They are the most discriminated-against and neglected group in the U.S., which has become probably the worst place in the developed world to be mentally ill.
In many previous blog posts I have bemoaned the shameful state of psychiatric care and housing for people with severe mental illness. My conclusion was that the United States has become the worst place, and now the worst time ever, to have a severe mental illness. Hundreds of thousands of the severely ill languish inappropriately in prisons. Additional hundreds of thousands are homeless on the street.
The entire blog post is here.
Sunday, January 18, 2015
Why the Myers-Briggs test is totally meaningless
By Joseph Stromberg
Vox
Published on January 5, 2015
The Myers-Briggs Type Indicator is probably the most widely used personality test in the world.
An estimated 2 million people take it annually, at the behest of corporate HR departments, colleges, and even government agencies. The company that makes and markets the test makes somewhere around $20 million each year.
The only problem? The test is completely meaningless.
"There's just no evidence behind it," says Adam Grant, an organizational psychologist at the University of Pennsylvania who's written about the shortcomings of the Myers-Briggs previously. "The characteristics measured by the test have almost no predictive power on how happy you'll be in a situation, how you'll perform at your job, or how happy you'll be in your marriage."
The entire article is here.
Vox
Published on January 5, 2015
The Myers-Briggs Type Indicator is probably the most widely used personality test in the world.
An estimated 2 million people take it annually, at the behest of corporate HR departments, colleges, and even government agencies. The company that makes and markets the test makes somewhere around $20 million each year.
The only problem? The test is completely meaningless.
"There's just no evidence behind it," says Adam Grant, an organizational psychologist at the University of Pennsylvania who's written about the shortcomings of the Myers-Briggs previously. "The characteristics measured by the test have almost no predictive power on how happy you'll be in a situation, how you'll perform at your job, or how happy you'll be in your marriage."
The entire article is here.
Saturday, January 17, 2015
New test measures doctors' ability to deliver patient-centered care
University of Missouri-Columbia
News Release
Originally released December 29, 2014
When health care providers take patients' perspectives into consideration, patients are more likely to be actively engaged in their treatment and more satisfied with their care. This is called patient-centered care, and it has been the central focus of the curriculum at the University of Missouri School of Medicine since 2005. Recently, MU researchers have developed a credible tool to assess whether medical students have learned and are applying specific behaviors that characterize patient-centered care.
The researchers first worked with real patients to identify a list of specific behaviors that demonstrated physicians were providing patient-centered care. By defining these detailed, specific patient-centered behaviors, the researchers have been able to tailor the educational experience at the MU School of Medicine to help students gain these skills.
MU medical students now are assessed on their ability to deliver the care in ways the patients expect; students must perform at a satisfactory level on the patient-centered care exam to graduate from the MU School of Medicine.
(cut)
From this authentic assessment, researchers learned students were picking up on many key factors in patient-centered care. Most MU medical students had strong, effective communication skills, didn't use medical jargon, actively listened to the patient, showed empathy and were in charge of the situation when they needed to lead a critical conversation.
The entire press release is here.
News Release
Originally released December 29, 2014
When health care providers take patients' perspectives into consideration, patients are more likely to be actively engaged in their treatment and more satisfied with their care. This is called patient-centered care, and it has been the central focus of the curriculum at the University of Missouri School of Medicine since 2005. Recently, MU researchers have developed a credible tool to assess whether medical students have learned and are applying specific behaviors that characterize patient-centered care.
The researchers first worked with real patients to identify a list of specific behaviors that demonstrated physicians were providing patient-centered care. By defining these detailed, specific patient-centered behaviors, the researchers have been able to tailor the educational experience at the MU School of Medicine to help students gain these skills.
MU medical students now are assessed on their ability to deliver the care in ways the patients expect; students must perform at a satisfactory level on the patient-centered care exam to graduate from the MU School of Medicine.
(cut)
From this authentic assessment, researchers learned students were picking up on many key factors in patient-centered care. Most MU medical students had strong, effective communication skills, didn't use medical jargon, actively listened to the patient, showed empathy and were in charge of the situation when they needed to lead a critical conversation.
The entire press release is here.
Friday, January 16, 2015
The effects of punishment and appeals for honesty on children’s truth-telling behavior
By Victoria Talwar, Cindy Arruda, & Sarah Yachison
Journal of Experimental Child Psychology
Volume 130, February 2015, Pages 209–217
Abstract
This study examined the effectiveness of two types of verbal appeals (external and internal motivators) and expected punishment in 372 children’s (4- to 8-year-olds) truth-telling behavior about a transgression. External appeals to tell the truth emphasized social approval by stating that the experimenter would be happy if the children told the truth. Internal appeals to tell the truth emphasized internal standards of behavior by stating that the children would be happy with themselves if they told the truth. Results indicate that with age children are more likely to lie and maintain their lie during follow-up questioning. Overall, children in the External Appeal conditions told the truth significantly more compared with children in the No Appeal conditions. Children who heard internal appeals with no expected punishment were significantly less likely to lie compared with children who heard internal appeals when there was expected punishment. The results have important implications regarding the impact of socialization on children’s honesty and promoting children’s veracity in applied situations where children’s honesty is critical.
Highlights
• The effectiveness of verbal appeals and punishment on children’s honesty was examined.
• External appeals emphasized the importance of truth-telling for social approval.
• Internal appeals emphasized internal standards of behavior.
•Overall children in the external appeal conditions were least likely to lie.
•The efficacy of internal appeals was attenuated by expected punishment.
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