Maria Panagioti, Keith Geraghty, Judith Johnson
JAMA Intern Med. 2018;178(10):1317-1330.
doi:10.1001/jamainternmed.2018.3713
Abstract
Objective To examine whether physician burnout is associated with an increased risk of patient safety incidents, suboptimal care outcomes due to low professionalism, and lower patient satisfaction.
Data Sources MEDLINE, EMBASE, PsycInfo, and CINAHL databases were searched until October 22, 2017, using combinations of the key terms physicians, burnout, and patient care. Detailed standardized searches with no language restriction were undertaken. The reference lists of eligible studies and other relevant systematic reviews were hand-searched.
Study Selection Quantitative observational studies.
Data Extraction and Synthesis Two independent reviewers were involved. The main meta-analysis was followed by subgroup and sensitivity analyses. All analyses were performed using random-effects models. Formal tests for heterogeneity (I2) and publication bias were performed.
Main Outcomes and Measures The core outcomes were the quantitative associations between burnout and patient safety, professionalism, and patient satisfaction reported as odds ratios (ORs) with their 95% CIs.
Results Of the 5234 records identified, 47 studies on 42 473 physicians (25 059 [59.0%] men; median age, 38 years [range, 27-53 years]) were included in the meta-analysis. Physician burnout was associated with an increased risk of patient safety incidents (OR, 1.96; 95% CI, 1.59-2.40), poorer quality of care due to low professionalism (OR, 2.31; 95% CI, 1.87-2.85), and reduced patient satisfaction (OR, 2.28; 95% CI, 1.42-3.68). The heterogeneity was high and the study quality was low to moderate. The links between burnout and low professionalism were larger in residents and early-career (≤5 years post residency) physicians compared with middle- and late-career physicians (Cohen Q = 7.27; P = .003). The reporting method of patient safety incidents and professionalism (physician-reported vs system-recorded) significantly influenced the main results (Cohen Q = 8.14; P = .007).
Conclusions and Relevance This meta-analysis provides evidence that physician burnout may jeopardize patient care; reversal of this risk has to be viewed as a fundamental health care policy goal across the globe. Health care organizations are encouraged to invest in efforts to improve physician wellness, particularly for early-career physicians. The methods of recording patient care quality and safety outcomes require improvements to concisely capture the outcome of burnout on the performance of health care organizations.
Saturday, November 10, 2018
Friday, November 9, 2018
Believing without evidence is always morally wrong
Francisco Mejia Uribe
aeon.co
Originally posted November 5, 2018
Here are two excerpts:
But it is not only our own self-preservation that is at stake here. As social animals, our agency impacts on those around us, and improper believing puts our fellow humans at risk. As Clifford warns: ‘We all suffer severely enough from the maintenance and support of false beliefs and the fatally wrong actions which they lead to …’ In short, sloppy practices of belief-formation are ethically wrong because – as social beings – when we believe something, the stakes are very high.
(cut)
Translating Clifford’s warning to our interconnected times, what he tells us is that careless believing turns us into easy prey for fake-news peddlers, conspiracy theorists and charlatans. And letting ourselves become hosts to these false beliefs is morally wrong because, as we have seen, the error cost for society can be devastating. Epistemic alertness is a much more precious virtue today than it ever was, since the need to sift through conflicting information has exponentially increased, and the risk of becoming a vessel of credulity is just a few taps of a smartphone away.
Clifford’s third and final argument as to why believing without evidence is morally wrong is that, in our capacity as communicators of belief, we have the moral responsibility not to pollute the well of collective knowledge. In Clifford’s time, the way in which our beliefs were woven into the ‘precious deposit’ of common knowledge was primarily through speech and writing. Because of this capacity to communicate, ‘our words, our phrases, our forms and processes and modes of thought’ become ‘common property’. Subverting this ‘heirloom’, as he called it, by adding false beliefs is immoral because everyone’s lives ultimately rely on this vital, shared resource.
The info is here.
aeon.co
Originally posted November 5, 2018
Here are two excerpts:
But it is not only our own self-preservation that is at stake here. As social animals, our agency impacts on those around us, and improper believing puts our fellow humans at risk. As Clifford warns: ‘We all suffer severely enough from the maintenance and support of false beliefs and the fatally wrong actions which they lead to …’ In short, sloppy practices of belief-formation are ethically wrong because – as social beings – when we believe something, the stakes are very high.
(cut)
Translating Clifford’s warning to our interconnected times, what he tells us is that careless believing turns us into easy prey for fake-news peddlers, conspiracy theorists and charlatans. And letting ourselves become hosts to these false beliefs is morally wrong because, as we have seen, the error cost for society can be devastating. Epistemic alertness is a much more precious virtue today than it ever was, since the need to sift through conflicting information has exponentially increased, and the risk of becoming a vessel of credulity is just a few taps of a smartphone away.
Clifford’s third and final argument as to why believing without evidence is morally wrong is that, in our capacity as communicators of belief, we have the moral responsibility not to pollute the well of collective knowledge. In Clifford’s time, the way in which our beliefs were woven into the ‘precious deposit’ of common knowledge was primarily through speech and writing. Because of this capacity to communicate, ‘our words, our phrases, our forms and processes and modes of thought’ become ‘common property’. Subverting this ‘heirloom’, as he called it, by adding false beliefs is immoral because everyone’s lives ultimately rely on this vital, shared resource.
The info is here.
Why Do Christian Women Continue to Have Abortions?
Marvin G. Thompson
The Christian Post
Originally posted November 3, 2018
Here is an excerpt:
According to Abortion Statistics compiled by the Antiochian Orthodox Christian Archdiocese of North America, '"Women identifying themselves as Protestants obtain 37.4% of all abortions in the U.S.; Catholic women account for 31.3%, Jewish women account for 1.3%, and women with no religious affiliation obtain 23.7% of all abortions. 18% of all abortions are performed on women who identify themselves as "Born-again/Evangelical."'
It is significant to note that only 23.7% of women obtaining abortions are not religious. That means 76.3% of all abortions are obtained by "God-fearing" women – with 68.7% identified as Christian women; and 18% of all abortions are obtained by "born-again/evangelical" women.
The official stated position of the Church does not seem to translate to requisite practice by church-going Christians. That fact was recently borne out in a study Commissioned by Care Net showing that 4 in 10 women having an abortion are churchgoers. In that study it is shown that in a survey of 1,038 women having an abortion, "70 percent claim a Christian religious preference, and 43 percent report attending church monthly or more at the time of an abortion."
The info is here.
The Christian Post
Originally posted November 3, 2018
Here is an excerpt:
According to Abortion Statistics compiled by the Antiochian Orthodox Christian Archdiocese of North America, '"Women identifying themselves as Protestants obtain 37.4% of all abortions in the U.S.; Catholic women account for 31.3%, Jewish women account for 1.3%, and women with no religious affiliation obtain 23.7% of all abortions. 18% of all abortions are performed on women who identify themselves as "Born-again/Evangelical."'
It is significant to note that only 23.7% of women obtaining abortions are not religious. That means 76.3% of all abortions are obtained by "God-fearing" women – with 68.7% identified as Christian women; and 18% of all abortions are obtained by "born-again/evangelical" women.
The official stated position of the Church does not seem to translate to requisite practice by church-going Christians. That fact was recently borne out in a study Commissioned by Care Net showing that 4 in 10 women having an abortion are churchgoers. In that study it is shown that in a survey of 1,038 women having an abortion, "70 percent claim a Christian religious preference, and 43 percent report attending church monthly or more at the time of an abortion."
The info is here.
Thursday, November 8, 2018
Do We Need To Teach Ethics And Empathy To Data Scientists?
Kalev Leetaru
One of the most frightening aspects of the modern web is the speed at which it has struck down decades of legislation and professional norms regarding personal privacy and the ethics of turning ordinary citizens into laboratory rats to be experimented on against their wills. In the space of just two decades the online world has weaponized personalization and data brokering, stripped away the last vestiges of privacy, centralized control over the world’s information and communications channels, changed the public’s understanding of the right over their digital selves and profoundly reshaped how the scholarly world views research ethics, informed consent and the right to opt out of being turned into a digital guinea pig.
It is the latter which in many ways has driven each of the former changes. Academia’s changing views towards IRB and ethical review has produced a new generation of programmers and data scientists who view research ethics as merely an outdated obsolete historical relic that was an obnoxious barrier preventing them from doing as they pleased to an unsuspecting public.
(cut)
Ironically, however, when asked whether she would consent to someone mass harvesting all of her own personal information from all of the sites she has willingly signed up for over the years, the answer was a resounding no. When asked how she reconciled the difference between her view that users of platforms willingly relinquish their right to privacy, while her own data should be strictly protected, she was unable to articulate a reason other than that those who create and study the platforms are members of the “societal elite” who must be granted an absolute right to privacy, while “ordinary” people can be mined and manipulated at will. Such an empathy gap is common in the technical world, in which people’s lives are dehumanized into spreadsheets of numbers that remove any trace of connection or empathy.
The info is here.
Forbes.com
Originally posted October 8, 2018
Here is an excerpt:
One of the most frightening aspects of the modern web is the speed at which it has struck down decades of legislation and professional norms regarding personal privacy and the ethics of turning ordinary citizens into laboratory rats to be experimented on against their wills. In the space of just two decades the online world has weaponized personalization and data brokering, stripped away the last vestiges of privacy, centralized control over the world’s information and communications channels, changed the public’s understanding of the right over their digital selves and profoundly reshaped how the scholarly world views research ethics, informed consent and the right to opt out of being turned into a digital guinea pig.
It is the latter which in many ways has driven each of the former changes. Academia’s changing views towards IRB and ethical review has produced a new generation of programmers and data scientists who view research ethics as merely an outdated obsolete historical relic that was an obnoxious barrier preventing them from doing as they pleased to an unsuspecting public.
(cut)
Ironically, however, when asked whether she would consent to someone mass harvesting all of her own personal information from all of the sites she has willingly signed up for over the years, the answer was a resounding no. When asked how she reconciled the difference between her view that users of platforms willingly relinquish their right to privacy, while her own data should be strictly protected, she was unable to articulate a reason other than that those who create and study the platforms are members of the “societal elite” who must be granted an absolute right to privacy, while “ordinary” people can be mined and manipulated at will. Such an empathy gap is common in the technical world, in which people’s lives are dehumanized into spreadsheets of numbers that remove any trace of connection or empathy.
The info is here.
Code of Ethics Doesn’t Influence Decisions of Software Developers
Emerson Murphy-Hill, Justin Smith, & Matt Shipman
NC State Pressor
Originally released October 8, 2018
The world’s largest computing society, the Association for Computing Machinery (ACM), updated its code of ethics in July 2018 – but new research from North Carolina State University shows that the code of ethics does not appear to affect the decisions made by software developers.
“We applauded the decision to update the ACM code of ethics, but wanted to know whether it would actually make a difference,” says Emerson Murphy-Hill, co-author of a paper on the work and an adjunct associate professor of computer science at NC State.
“This issue is timely, given the tech-related ethics scandals in the news in recent years, such as when Volkwagen manipulated its technology that monitored vehicle emissions. And developers will continue to face work-related challenges that touch on ethical issues, such as the appropriate use of artificial intelligence.”
For the study, researchers developed 11 written scenarios involving ethical challenges, most of which were drawn from real-life ethical questions posted by users on the website Stack Overflow. The study included 105 U.S. software developers with five or more years of experience and 63 software engineering graduate students at a university. Half of the study participants were shown a copy of the ACM code of ethics, the other half were simply told that ethics are important as part of an introductory overview of the study. All study participants were then asked to read each scenario and state how they would respond to the scenario.
“There was no significant difference in the results – having people review the code of ethics beforehand did not appear to influence their responses,” Murphy-Hill says.
The press release is here.
The research is here.
NC State Pressor
Originally released October 8, 2018
The world’s largest computing society, the Association for Computing Machinery (ACM), updated its code of ethics in July 2018 – but new research from North Carolina State University shows that the code of ethics does not appear to affect the decisions made by software developers.
“We applauded the decision to update the ACM code of ethics, but wanted to know whether it would actually make a difference,” says Emerson Murphy-Hill, co-author of a paper on the work and an adjunct associate professor of computer science at NC State.
“This issue is timely, given the tech-related ethics scandals in the news in recent years, such as when Volkwagen manipulated its technology that monitored vehicle emissions. And developers will continue to face work-related challenges that touch on ethical issues, such as the appropriate use of artificial intelligence.”
For the study, researchers developed 11 written scenarios involving ethical challenges, most of which were drawn from real-life ethical questions posted by users on the website Stack Overflow. The study included 105 U.S. software developers with five or more years of experience and 63 software engineering graduate students at a university. Half of the study participants were shown a copy of the ACM code of ethics, the other half were simply told that ethics are important as part of an introductory overview of the study. All study participants were then asked to read each scenario and state how they would respond to the scenario.
“There was no significant difference in the results – having people review the code of ethics beforehand did not appear to influence their responses,” Murphy-Hill says.
The press release is here.
The research is here.
Wednesday, November 7, 2018
Hospitals are fed up with drug companies, so they’re starting their own
Carolyn JohnsonThe Washington Post
Originally posted September 6, 2018
A group of major American hospitals, battered by price spikes on old drugs and long-lasting shortages of critical medicines, has launched a mission-driven, not-for-profit generic drug company, Civica Rx, to take some control over the drug supply.
Backed by seven large health systems and three philanthropic groups, the new venture will be led by an industry insider who refuses to draw a salary. The company will focus initially on establishing price transparency and stable supplies for 14 generic drugs used in hospitals, without pressure from shareholders to issue dividends or push a stock price higher.
“We’re trying to do the right thing — create a first-of-its-kind societal asset with one mission: to make sure essential generic medicines are affordable and available to everyone,” said Dan Liljenquist, chair of Civica Rx and chief strategy officer at Intermountain Healthcare in Utah.
The consortium, which includes health systems such as the Mayo Clinic and HCA Healthcare, collectively represents about 500 hospitals. Liljenquist said that the initial governing members have already committed $100 million to the effort. The business model will ultimately rely on the long-term contracts that member health care organizations agree to — a commitment to buy a fixed portion of their drug volume from Civica.
The info is here.
Japan Set to Allow Gene Editing in Human Embryos
David Cyranoski
Scientific American
Originally posted on October 3, 2018
Japan has issued draft guidelines that allow the use of gene-editing tools in human embryos. The proposal was released by an expert panel representing the country’s health and science ministries on 28 September.
Although the country regulates the use of human embryos for research, there have been no specific guidelines on using tools such as CRISPR–Cas9 to make precise modifications in their DNA until now.
Tetsuya Ishii, a bioethicist at Hokkaido University in Sapporo, says that before the draft guidelines were issued, Japan’s position on gene editing in human embryos was neutral. The proposal now encourages this kind of research, he says.
But if adopted, the guidelines would restrict the manipulation of human embryos for reproduction, although this would not be legally binding.
Manipulating DNA in embryos could reveal insights into early human development. Researchers also hope that in the long term, these tools could be used to fix genetic mutations that cause diseases, before they are passed on.
The info is here.
Scientific American
Originally posted on October 3, 2018
Japan has issued draft guidelines that allow the use of gene-editing tools in human embryos. The proposal was released by an expert panel representing the country’s health and science ministries on 28 September.
Although the country regulates the use of human embryos for research, there have been no specific guidelines on using tools such as CRISPR–Cas9 to make precise modifications in their DNA until now.
Tetsuya Ishii, a bioethicist at Hokkaido University in Sapporo, says that before the draft guidelines were issued, Japan’s position on gene editing in human embryos was neutral. The proposal now encourages this kind of research, he says.
But if adopted, the guidelines would restrict the manipulation of human embryos for reproduction, although this would not be legally binding.
Manipulating DNA in embryos could reveal insights into early human development. Researchers also hope that in the long term, these tools could be used to fix genetic mutations that cause diseases, before they are passed on.
The info is here.
Tuesday, November 6, 2018
The removal of Darwin and evolution from schools is a backwards step
Michael Dixon
The Guardian
Originally posted in October 3, 2018
In recent weeks there have been alarming reports from both Israel and Turkey of Charles Darwin’s theory of evolution being erased from school curriculums. In Turkey, this has been blamed on the concept of evolution – which is taught in British primary schools – being beyond the understanding of high school students. In Israel, teachers are claiming that most students do not learn about evolution; they say their education ministry is quietly encouraging teachers to focus on other topics in biology.
This news follows the astonishing statements made by India’s minister for higher education earlier this year. Satyapal Singh claimed Darwin was “scientifically wrong”, and is demanding that the theory of evolution be removed from school curriculums because no one “ever saw an ape turning into a human being”.
It is tempting to shrug off these latest attacks on Darwin’s greatest contribution to natural science. After all, no other scientific theory has attracted the same level of impassioned opposition and detraction – certainly not for more than 150 years. But that would be to miss the particular urgency of improving our scientific understanding of the natural world and how best to protect it for the future.
The info is here.
The Guardian
Originally posted in October 3, 2018
In recent weeks there have been alarming reports from both Israel and Turkey of Charles Darwin’s theory of evolution being erased from school curriculums. In Turkey, this has been blamed on the concept of evolution – which is taught in British primary schools – being beyond the understanding of high school students. In Israel, teachers are claiming that most students do not learn about evolution; they say their education ministry is quietly encouraging teachers to focus on other topics in biology.
This news follows the astonishing statements made by India’s minister for higher education earlier this year. Satyapal Singh claimed Darwin was “scientifically wrong”, and is demanding that the theory of evolution be removed from school curriculums because no one “ever saw an ape turning into a human being”.
It is tempting to shrug off these latest attacks on Darwin’s greatest contribution to natural science. After all, no other scientific theory has attracted the same level of impassioned opposition and detraction – certainly not for more than 150 years. But that would be to miss the particular urgency of improving our scientific understanding of the natural world and how best to protect it for the future.
The info is here.
Bringing back professionalism in the practice of law is key
Samuel C. Stretton
The Legal Intelligencer
Originally published October 4, 2018
Here is an excerpt:
All lawyers ought to review the Pennsylvania Rules of Civility. Although these rules do not have disciplinary consequences, they set forth the aspirations all lawyers should achieve in the legal profession. Perhaps lawyers have to understand what it means to be a professional. To have the privilege of being admitted to practice law in a state is a wonderful opportunity. The lawyer being admitted becomes part of the legal profession which has a long and historic presence. The legal profession can take great credit for the evolving law and for the democratic institutions which populate this country. Lawyers through vigorous advocacy and through much involvement in the community and in the political offices have help to create a society by law where fairness and justice are the ideals. Once admitted to practice, each and every lawyer becomes part of this wonderful profession and has a duty to uphold the ideals not only in terms of representing clients as vigorously and as honestly as they can, but also in terms of insuring involvement in the community and in society. Each generation of lawyers help to reinterpret the constitution and make it a living document to adjust to the modern problems of every generation. It is a wonderful and great honor to be part of this profession and perhaps one of the greatest privileges any lawyer can have. This privilege allows a lawyer to participate fully in the third branch of public. This privilege allows a lawyer to become part of the public life of their community and of the country in terms of representation and in terms of legal and judicial changes.
The information is here.
The Legal Intelligencer
Originally published October 4, 2018
Here is an excerpt:
All lawyers ought to review the Pennsylvania Rules of Civility. Although these rules do not have disciplinary consequences, they set forth the aspirations all lawyers should achieve in the legal profession. Perhaps lawyers have to understand what it means to be a professional. To have the privilege of being admitted to practice law in a state is a wonderful opportunity. The lawyer being admitted becomes part of the legal profession which has a long and historic presence. The legal profession can take great credit for the evolving law and for the democratic institutions which populate this country. Lawyers through vigorous advocacy and through much involvement in the community and in the political offices have help to create a society by law where fairness and justice are the ideals. Once admitted to practice, each and every lawyer becomes part of this wonderful profession and has a duty to uphold the ideals not only in terms of representing clients as vigorously and as honestly as they can, but also in terms of insuring involvement in the community and in society. Each generation of lawyers help to reinterpret the constitution and make it a living document to adjust to the modern problems of every generation. It is a wonderful and great honor to be part of this profession and perhaps one of the greatest privileges any lawyer can have. This privilege allows a lawyer to participate fully in the third branch of public. This privilege allows a lawyer to become part of the public life of their community and of the country in terms of representation and in terms of legal and judicial changes.
The information is here.
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