Medical Ethics in the Doctor's Office

Like this item from the Kevin MD blog.

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We physicians face ethical dilemmas every day in the mundane world of our medical practices. They won’t appear in your newspapers or pop up on your smart phones, but they are real and they are important.

Here is a sampling from the everyday ethical smorgasbord that your doctor faces. How would you act under the following scenarios?

Link to blog here.

The Perfect Storm: Disaster Ethics Symposium and Public Forum

Wednesday, December 7, 2011
Symposium: 8 am to 4 pm
Public Forum: 6 pm

Kansas City Public Library
Plaza Branch
Truman Forum Auditorium
4801 Main Street
Kansas City, Missouri 64112

The Center for Practical Bioethics is hosting a symposium and forum on the ethics of disasters on December 7 at the Kansas City Public Library-Plaza Branch. The symposium features presentations by medical professionals who were on the scene during the Hyatt Hotel disaster in Kansas City, Hurricane Katrina in New Orleans, and the tornado that ripped through Joplin, Missouri in May 2011.

Continuing education credits are available for the symposium.

At 6 pm that evening, a public forum is scheduled with Anna Pou, MD, who spent nearly a week in Memorial Hospital in New Orleans after Hurricane Katrina hit in 2005. Registration for the public forum is $15.

For more information and to register click here.

The Center for Practical Bioethics is sponsoring this program in partnership with the Missouri Humanities Council and with support from the National Endowment for the Humanities, along with support from:

Missouri Hospital Association
Kansas Hospital Association
Kansas City Metropolitan Healthcare Association
Saint Luke's Health System
Department of History and Philosophy of Medicine, University of Kansas Medical Center and Kansas University Endowment Association
Sirridge Office of Medical Humanities and Bioethics/University of Missouri-Kansas City School of Medicine
Children's Mercy Hospitals and Clinics

Transparency in Organ Donations

Supporters of the new rules argue that the guidelines will ensure that a patient's wish to donate his organs will be respected. Critics, however, state that the proposed changes run the risk of dehumanizing patients into mere sources for materials.

Links:

Catholic ethicist calls for transparency in organ donor controversy, Marianne Medlin
Catholic News Agency, September 24, 2011
Changes in controversial organ donation method stir fears, Washington Post, September 20
Resuscitating the Dead Donor Rule, David Magnus, The Bioethics Channel

Nurses Treating Pain

Pamela Bennett
Ann Schreier

Nurses play an important role in pain management. Two nurses -- Ann Schreier of the American Society for Pain Management Nursing and Pamela Bennett of Purdue Pharma -- talk about it in this edition of The Bioethics Channel.

Educational Links: Disparities in Pain Management
**Article: Unequal Access to Pain Treatment, State Initiatives in End of Life Care
**Podcast: Chronic Pain and Health Disparities, September Williams, MD, The Bioethics Channel

End of Life and Public Health

Lynda Anderson
An online course sponsored by the Centers for Disease Control is designed to equip professionals at public health departments and aging services networks with the tools to discuss advance care planning with their clients.

Lynda Anderson of the CDC explains in this edition of The Bioethics Channel.

Link to podcast here.

No Pill for Chronic Pain

Bob Twillman, PhD

American Academy of Pain Management

If there was one thing I could do to relieve pain in America, it would be to have everyone understand that no pill, no shot, no surgery will relieve the vast majority of chronic pain.

Chronic pain is relieved only when there is a joint effort, on many fronts, of the person with pain, his or her healthcare providers, and those in his or her social milieu, to address ALL of the aspects of pain. This means focusing not only on the biological components of pain, but also on its behavioral, cognitive, emotional, social, and spiritual aspects.

By attending to all of these components of the pain experience, it may be possible for people with chronic pain to return to wellness, even if their pain does not completely go away. That is to say, they may be well emotionally, spiritually, cognitively, behaviorally, and socially even if they continue to experience some pain.

That state of overall wellness should be the goal for which we strive in treating chronic pain.

Note: September is Pain Awareness Month. For information on activities conducted by the Center for Practical Bioethics click here.

The Moral Culpability of Guatemala

Summer McGee, PhD

The Presidential Commission for the Study of Bioethical Issues holds US doctors and researchers morally culpable for experiments involving hundreds of people from 1946 to 1948. Lorell LaBoube visits with Summer McGee about this report in this edition of The Bioethics Channel.

Link to podcast here.

Corporate Responsibility for Clinical Misadventures

Kenneth Kipnis

Where is the boundary between marketing and medical education? And at what point does a corporation become responsible?

Those are the questions posed by Kenneth Kipnis in the September 2011 issue of The American Journal of Bioethics. Host Lorell LaBoube discusses the article with Professor Kipnis in this edition of The Bioethics Channel.

Link to podcast here.

Wisconsin - Missouri 2005?

Here's a case of deja vu all over again. Language, arguments in Wisconsin virtually the same as debate in Missouri in 2005.

For more click here.

Research at risk
Editorial
Milwaukee Journal Sentinel
Sept. 12, 2011

Identical bills introduced by Republicans in the state Assembly and Senate would make it a crime for researchers in Wisconsin to use cells derived from fetal tissue.

A ban would put an end to research in labs at the University of Wisconsin-Madison and the Medical College of Wisconsin and would almost certainly lead to an exodus of both scientists and the companies that are putting their research to work.

Bioethicists will pay for proof of Bachman HPV claim

Scott Hensley
Shots – NPR Health Blog
September 15, 2011

Dr. Steven Miles, a bioethicist at the University of Minnesota, has ponied up $1,000 if the mother Bachmann talked about can produce medical proof that her daughter suffered mental retardation from the HPV vaccine, the Star Tribune reports.

"These types of messages in this climate have the capacity to do enormous public health harm," Miles told the paper. "It's an extremely serious claim and it deserves to be analyzed."

For more click here.

If there's one thing I would do to relieve pain in America ...

Daniel S. Goldberg, JD, PhD

East Carolina University

I would do everything in my power to convince both providers and pain sufferers to rid themselves of the idea that one must be able to see and objectify pain in order for it to be legitimized and treated properly.

The capacity to correlate discrete, material pathologies with illness complaints is a phenomenon that is literally constitutive of Western allopathic medicine, from the early 19th century to the present. As the quintessential subjective experience, pain defies objectification, and the vast majority of chronic pain experiences are literally defined by the absence of a material lesion that can be so correlated.

Yet such clinical sight is simply not necessary either to validate the experiences of those who live with pain, or to use the various safe and effective remedies that exist to ameliorate such pain.

I also believe that this emphasis on objectification and visibility plays a role in the terrible prevalence and intensity of chronic pain stigma and inequities in diagnosing and treating pain, but laying out the argument is a subject for future posts . . .

Ultimately, the need to objectify and see pain, which has been documented among pain sufferers and caregivers as well as health care providers, is in my view a primary culprit in the devastating and inequitable undertreatment of pain.

Even though such a need is literally baked into the foundations of American medicine and science, we should reject it.

Link: Ethics and the Chronic Pain Stigma in Geriatric Populations, Daniel Goldberg, The Bioethics Channel

Lectures in Bioethics: August 2011

Here are the Top 10 Lectures in Bioethics for August 2011.

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Bioethics and the Underserved: Culture, Values and Justice, Richard Payne, MD
The Role of Conscience in Medical Decisions, Daniel Sulmasy, MD
Systems Reform and Innovation, Robert St. Peter, MD
I'm dying STAT! Call my -- lawyer? Bill Colby, JD
Chronic Disease and Aging, John Carney
A Physician's Reflections on Bioethics, Robert Potter, MD
Religion. Healthcare. Do the Twain Meet?, Rosemary Flanigan
Health care reform needed but comes hard, Steven Schroeder, MD
The Ethics of Living Forever, Glenn McGee, PhD
The Politics of Palliative Care, Kathleen Foley, MD

Webinar: The IOM Report - Relieving Pain in America

A webinar sponsored by the Center for Practical Bioethics

Thursday, October 6, 2011
10 AM Central

Registration:
Member Rate: $15
Nonmember Rate: $25

On June 30 the Institute of Medicine released a landmark report on pain, Relieving Pain in America: A Blueprint for Transforming Prevention, Care, Education, and Research. Since then, individuals and organizations devoted to advancing quality pain treatment for all Americans have been investigating ways to carry through on the IOM report’s recommendations.

Myra Christopher, president and CEO of the Center for Practical Bioethics and holder of the Kathleen M. Foley Chair for Pain and Palliative Care, served on the IOM committee that developed this report. In this webinar, Christopher presents an overview of the report.

Registration:

$15 if you are a member of the Center for Practical Bioethics. Click here to register.

$25 for nonmembers. Click here to register.

Linking information will be sent your way following your registration.

If you have a question about your membership status, please email Lorell LaBoube at llaboube@practicalbioethics.org.

Introducing: A New Online Course on Advance Care Planning

A new on-line course is now available from the Centers for Disease Control Healthy Aging Program.

Entitled Advance Care Planning: An Introduction for Public Health and Aging Services Professionals, the course was developed by CDC in partnership with Myra Christopher, President and CEO of the Center for Practical Bioethics, and the Directors of Health Promotion and Education.

The goal of the course is to equip professionals in the public health and aging services networks with the information and resources needed to assist their clients in better understanding issues related to advance care planning.

For more information click here.

Defining Chronic Pain Ethics

September is Pain Awareness Month

There is a nationwide consensus developing around the ethical issues involved in the diagnosis and treatment of chronic pain. That’s according to an article in the September 2011 issue of Pain Medicine entitled “Defining Chronic Pain Ethics.”

Two of the authors of the article talk about it in this edition of The Bioethics Channel. For more information on September as Pain Awareness Month click here.

Educational Links:

Publication: Medical Professionalism and Responsibility in Pain Management, Practical Bioethics

Podcast: The Ethics of Untreated Pain, Richard Payne, MD

The Bioethics Channel: Top 10 August 2011

A wide range of topics covered in the August Top 10 for The Bioethics Channel - from the ethics of healthcare information exchanges and rationing medical care to nursing and medical ethics and the dead donor rule.

If you have any ideas on topics or speakers please contact me at:
practicalbioethics@gmail.com.

Legal and Ethical? Healthcare Information Exchanges, Jeff Ellis, JD and Glenn McGee, PhD

End of Life Status and POLST, Charles Sabatino, JD

Bridging the Divide: Nursing and Medical Ethics, Nelda Godfrey, RN and Noreen Thompson, RN

A Progress Report on Palliative Care, Carol Buller, RN, Christian Sinclair, MD, and Karin Porter Williamson, MD

The Standardized Patient, Walter Winch

Spirituality, Race and End of Life Care, Richard Payne, MD and Tarris Rosell, PhD

Rationing Just Medical Care, Lawrence Schneiderman, MD

The Elderly and Public Transportation, Tom Gerend

Resuscitating the Dead Donor Rule, David Magnus

Bioethics: Ripe for Transformation, Richard Payne, MD

Resuscitating the Dead Donor Rule

"Can the Dead Donor Rule be Resuscitated?" That's the title of an editorial in the August 2011 issue of The American Journal of Bioethics.

Editorial co-author David Magnus of the Stanford University Center for Biomedical Ethics addresses the question in this edition of The Bioethics Channel.

Link to podcast here.