A. M. Pena
American Journal of Bioethics (2015); 15(7): 70-1.
The Right to Refuse Life Sustaining Treatment
There is ethical and legal consensus that a patient has the right to refuse life-sustaining treatment (LST), as an expression of autonomy-based principles, when the patient demonstrates an appropriate degree of capacity, the decision is consistent with the patient's preferences and free from coercion, and when the burdens exceed the benefits of continued treatment. For the purposes of this discussion, I assume that the left ventricular assistance device (LVAD) is a form of LST and that it may be ethically permissible to deactivate the device, which is largely in accordance with professional and ethical consensus. As with other forms of LST, if the device is deactivated, then the patient would die from underlying physiological causes, namely, heart disease. My objective for this commentary, however, is to discuss whether depression can impair capacity to the extent that it is an ethical contraindication for withdrawing LST.
The article is here.
Sunday, March 20, 2016
Saturday, March 19, 2016
How America's criminal justice system became the country's mental health system
By German Lopez
Vox.com
Originally published March 1, 2016
Here are two excerpts:
It's a terrifying statistic: Someone with an untreated mental illness is 16 times more likely to be killed by police than other civilians approached or stopped by law enforcement, according to a 2015 report by the Treatment Advocacy Center.
(cut)
If people were getting comprehensive care and support, police most likely would not need to get involved in many of the circumstances that end up in horrible tragedies. But very often in the US, that's not happening.
Before Kevin broke into a neighbor's house and was arrested by police, Pete tried to take steps that would have prevented the whole encounter. Kevin had just suffered a psychotic episode in 2002, and Pete raced Kevin to emergency care to hopefully get Kevin into some form of long-term care, potentially against Kevin's will if necessary.
But doctors said they couldn't do anything because Kevin, an adult, didn't appear to pose a threat to himself or others in the four hours they sat in an emergency room. So he was let free, and within 48 hours, he went through the episode in which he broke into the neighbor's house.
The article is here.
Vox.com
Originally published March 1, 2016
Here are two excerpts:
It's a terrifying statistic: Someone with an untreated mental illness is 16 times more likely to be killed by police than other civilians approached or stopped by law enforcement, according to a 2015 report by the Treatment Advocacy Center.
(cut)
If people were getting comprehensive care and support, police most likely would not need to get involved in many of the circumstances that end up in horrible tragedies. But very often in the US, that's not happening.
Before Kevin broke into a neighbor's house and was arrested by police, Pete tried to take steps that would have prevented the whole encounter. Kevin had just suffered a psychotic episode in 2002, and Pete raced Kevin to emergency care to hopefully get Kevin into some form of long-term care, potentially against Kevin's will if necessary.
But doctors said they couldn't do anything because Kevin, an adult, didn't appear to pose a threat to himself or others in the four hours they sat in an emergency room. So he was let free, and within 48 hours, he went through the episode in which he broke into the neighbor's house.
The article is here.
Friday, March 18, 2016
Off-label Promotions: Pharma Wants More Freedom to Pitch Durgs
By Ed Silverman
Stat News
Originally published February 29, 2016
Drug makers have long argued that the Food and Drug Administration is squelching their free speech rights by barring off-label promotion of their medicines. A new proposal may give them a voice.
This month, a think tank at Duke University called for a new independent entity to review claims and recommend exactly what off-label information drug and device makers should be allowed to share with doctors.
Companies say current regulations prevent them from distributing important data to physicians about unapproved, off-label uses of their medicines. The FDA worries public health can be compromised if marketing claims aren’t backed up by solid evidence. A neutral third party, the authors of the white paper say, could provide much-needed arbitration.
The article is here.
Stat News
Originally published February 29, 2016
Drug makers have long argued that the Food and Drug Administration is squelching their free speech rights by barring off-label promotion of their medicines. A new proposal may give them a voice.
This month, a think tank at Duke University called for a new independent entity to review claims and recommend exactly what off-label information drug and device makers should be allowed to share with doctors.
Companies say current regulations prevent them from distributing important data to physicians about unapproved, off-label uses of their medicines. The FDA worries public health can be compromised if marketing claims aren’t backed up by solid evidence. A neutral third party, the authors of the white paper say, could provide much-needed arbitration.
The article is here.
Document Claims Drug Makers Deceived a Top Medical Journal
By Katie Thomas
The New York Times
Originally published March 1, 2016
It is a startling accusation, buried in a footnote in a legal briefing filed recently in federal court: Did two major pharmaceutical companies, in an effort to protect their blockbuster drug, mislead editors at one of the world’s most prestigious medical journals?
Lawyers for patients suing Johnson & Johnson and Bayer over the safety of the anticlotting drug Xarelto say the answer is yes, claiming that a letter published in The New England Journal of Medicine and written primarily by researchers at Duke University left out critical laboratory data. They claim the companies were complicit by staying silent, helping deceive the editors while the companies were in the midst of providing the very same data to regulators in the United States and Europe.
Duke and Johnson & Johnson contend that they worked independently of each other. Bayer declined to comment. And top editors at The New England Journal of Medicine said they did not know that separate laboratory data existed until a reporter contacted them last week, but they dismissed its relevance and said they stood by the article’s analysis.
The article is here.
The New York Times
Originally published March 1, 2016
It is a startling accusation, buried in a footnote in a legal briefing filed recently in federal court: Did two major pharmaceutical companies, in an effort to protect their blockbuster drug, mislead editors at one of the world’s most prestigious medical journals?
Lawyers for patients suing Johnson & Johnson and Bayer over the safety of the anticlotting drug Xarelto say the answer is yes, claiming that a letter published in The New England Journal of Medicine and written primarily by researchers at Duke University left out critical laboratory data. They claim the companies were complicit by staying silent, helping deceive the editors while the companies were in the midst of providing the very same data to regulators in the United States and Europe.
Duke and Johnson & Johnson contend that they worked independently of each other. Bayer declined to comment. And top editors at The New England Journal of Medicine said they did not know that separate laboratory data existed until a reporter contacted them last week, but they dismissed its relevance and said they stood by the article’s analysis.
The article is here.
Thursday, March 17, 2016
Why being good is a miracle
By Michael Bond
The New Scientist
Originally published March 9, 2016
Here is an excerpt:
A quick look at leading evolutionary anthropologist Michael Tomasello’s A Natural History of Human Morality will tell you that this flux in social norms is all of a piece with group psychology. Interests and identities within groups often seem to hold sway over those of individuals. This can seem irrational, but in the context of our evolutionary history it is anything but. Tomasello aims to describe not only how these “us and them” attitudes evolved, but also how they came to define our sense of right and wrong.
The article is here.
The New Scientist
Originally published March 9, 2016
Here is an excerpt:
A quick look at leading evolutionary anthropologist Michael Tomasello’s A Natural History of Human Morality will tell you that this flux in social norms is all of a piece with group psychology. Interests and identities within groups often seem to hold sway over those of individuals. This can seem irrational, but in the context of our evolutionary history it is anything but. Tomasello aims to describe not only how these “us and them” attitudes evolved, but also how they came to define our sense of right and wrong.
The article is here.
Cross-Sectional Analysis of the 1039 U.S. Physicians Reported to the National Practitioner Data Bank for Sexual Misconduct, 2003-2013
Azza AbuDagga , Sidney M. Wolfe , Michael Carome , Robert E. Oshel
PLoS ONE 11(2): e0147800.
Background
Little information exists on U.S. physicians who have been disciplined with licensure or restriction-of-clinical-privileges actions or have had malpractice payments because of sexual misconduct. Our objectives were to: (1) determine the number of these physicians and compare their age groups’ distribution with that of the general U.S. physician population; (2) compare the type of disciplinary actions taken against these physicians with actions taken against physicians disciplined for other offenses; (3) compare the characteristics and type of injury among victims of these physicians with those of victims in reports for physicians with other offenses in malpractice-payment reports; and (4) determine the percentages of physicians with clinical-privileges or malpractice-payment reports due to sexual misconduct who were not disciplined by medical boards.
The article is here.
PLoS ONE 11(2): e0147800.
Background
Little information exists on U.S. physicians who have been disciplined with licensure or restriction-of-clinical-privileges actions or have had malpractice payments because of sexual misconduct. Our objectives were to: (1) determine the number of these physicians and compare their age groups’ distribution with that of the general U.S. physician population; (2) compare the type of disciplinary actions taken against these physicians with actions taken against physicians disciplined for other offenses; (3) compare the characteristics and type of injury among victims of these physicians with those of victims in reports for physicians with other offenses in malpractice-payment reports; and (4) determine the percentages of physicians with clinical-privileges or malpractice-payment reports due to sexual misconduct who were not disciplined by medical boards.
The article is here.
Wednesday, March 16, 2016
Bill would allow therapists to refuse clients over religious beliefs
Holly Meyer
The Tennessean
Originally published March 2, 2016
A bill that would allow counselors and therapists to refuse to see clients whose cases violate their religious beliefs has taken a step forward in the Tennessee state House.
The bill, sponsored by Rep. Dan Howell, R-Georgetown, would let counselors and therapists refer clients without risking repercussions, such as a civil lawsuit or criminal action. The state House Health Subcommittee advanced the legislation Tuesday to the full committee.
The subcommittee recommended passage of the legislation with an amendment that changes the bill's language from "sincerely held religious beliefs" to "sincerely held principles."
The article is here.
The Tennessean
Originally published March 2, 2016
A bill that would allow counselors and therapists to refuse to see clients whose cases violate their religious beliefs has taken a step forward in the Tennessee state House.
The bill, sponsored by Rep. Dan Howell, R-Georgetown, would let counselors and therapists refer clients without risking repercussions, such as a civil lawsuit or criminal action. The state House Health Subcommittee advanced the legislation Tuesday to the full committee.
The subcommittee recommended passage of the legislation with an amendment that changes the bill's language from "sincerely held religious beliefs" to "sincerely held principles."
The article is here.
The Brain Gets Its Day in Court
By Greg Miller
The Atlantic
Originally published February 29, 2016
Here is an excerpt:
A handful of cases have made headlines in recent years, as lawyers representing convicted murderers have introduced brain scans and other tests of brain function to try to spare their client the death penalty. It didn’t always work, but Farahany’s analysis suggests that neuroscientific evidence—which she broadly defines as anything from brain scans to neuropsychological exams to bald assertions about the condition of a person’s brain—is being used in a wider variety of cases, and in the service of more diverse legal strategies, than the headlines would suggest. In fact, 60 percent of the cases in her sample involved non-capital offenses, including robbery, fraud, and drug trafficking.
Cases like Detrich’s are one example. Arguing for ineffective assistance of counsel is pretty much a legal Hail Mary. It requires proving two things: that the defense counsel failed to do their job adequately, and (raising the bar even higher) that this failure caused the trial to be unfairly skewed against the defendant. Courts have ruled previously that a defense attorney who slept through substantial parts of a trial still provided effective counsel. Not so, at least in some cases, for attorneys who failed to introduce neuroscience evidence in their client’s defense.
The article is here.
The Atlantic
Originally published February 29, 2016
Here is an excerpt:
A handful of cases have made headlines in recent years, as lawyers representing convicted murderers have introduced brain scans and other tests of brain function to try to spare their client the death penalty. It didn’t always work, but Farahany’s analysis suggests that neuroscientific evidence—which she broadly defines as anything from brain scans to neuropsychological exams to bald assertions about the condition of a person’s brain—is being used in a wider variety of cases, and in the service of more diverse legal strategies, than the headlines would suggest. In fact, 60 percent of the cases in her sample involved non-capital offenses, including robbery, fraud, and drug trafficking.
Cases like Detrich’s are one example. Arguing for ineffective assistance of counsel is pretty much a legal Hail Mary. It requires proving two things: that the defense counsel failed to do their job adequately, and (raising the bar even higher) that this failure caused the trial to be unfairly skewed against the defendant. Courts have ruled previously that a defense attorney who slept through substantial parts of a trial still provided effective counsel. Not so, at least in some cases, for attorneys who failed to introduce neuroscience evidence in their client’s defense.
The article is here.
Tuesday, March 15, 2016
Psychologist Jens Förster earns second and third retractions as part of settlement
by Shannon Palus
Retraction Watch
Originally published February 24, 2016
High-profile social psychologist Jens Förster has earned two retractions following an investigation by his former workplace. He agreed to the retractions as part of a settlement with the German Society for Psychology (DGPs).
The papers are two of eight that were found to contain “strong statistical evidence for low veracity.” According to the report from an expert panel convened at the request of the board of the University of Amsterdam, following:
Retraction Watch
Originally published February 24, 2016
High-profile social psychologist Jens Förster has earned two retractions following an investigation by his former workplace. He agreed to the retractions as part of a settlement with the German Society for Psychology (DGPs).
The papers are two of eight that were found to contain “strong statistical evidence for low veracity.” According to the report from an expert panel convened at the request of the board of the University of Amsterdam, following:
an extensive statistical analysis, the experts conclude that many of the experiments described in the articles show an exceptionally linear link. This linearity is not only surprising, but often also too good to be true because it is at odds with the random variation within the experiments.The post is here.
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