medical ethics

This article is cross-posted at Science-Based Medicine. Check it out. --PalMD In a previous post, I argued that placebo is an artifact of certain clinical interactions, rather than a treatment that we can exploit. Apparently, there are a whole lot of doctors out there who don't agree with me. Or are there? A recent study published in the British Medical Journal is getting a lot of enk (e-ink) in the blogosphere. As a practicing internist, I have some pretty strong opinions (based in fact, of course) about both this study and placebos in general. The Study The current BMJ study defines…

Ok, I pulled my post while considering ethical issues, viz this conversation: Dianne, PAL: I'm out of my depth here, so could you address what the ethical boundaries are for describing a case (even without personal identification) on an open board? I've always dealt with that one by Just Don't -- and I know it's overly conservative. And I promise to not take you as too authoritative, but it's an interesting subject ... Posted by: D. C. Sessions | October 15, 2008 9:09 PM Well, it's an interesting issue. Generally, cases are fine to present as long as enough details are changed. Given that I'…

Once again, I find myself straying into a political issue (although I'd argue that it's more a human rights issue). I understand that I'm probably in the minority in this country in my opposition to the death penalty. My fellow Americans generally vote to allow it, and my vote only counts once. One area where my opinion my carry a bit more weight (or maybe not) is in the area of medical ethics. Given that the death penalty is legal in the U.S., what role should doctors play? Troy Anthony Davis is a guy that Georgia wants dead so badly that they can't be bothered to wait for the U.S.…

This story is disturbing for a host of reasons, but there's a medical ethics issue hiding in here. Apparently, if you work for the Long Island Railroad, you can retire at 50, then claim disability for a job you no longer have, and collect both a disability check and a pension. I shit you not. But it gets better. According to the Times, "Virtually every career employee -- as many as 97 percent in one recent year -- applies for and gets disability payments soon after retirement...." I strongly encourage you to read the whole article, but let's focus on a particular point. Dr. Melhorn, who…

I've written often about the ethics of doctors and pharmacists imposing their own morals on their patients and customers. Our Sb pharmacologist has as well. And even though all of our legitimate professional organizations recognize this line, Bush's Department of Health and Human Services has jumped into the ring to join a fight that should never have started. And just to demonstrate how single-mindedly idiotic an evangelical (small "e") mindset can be when applied to medicine, PZ Myers, uber-atheist, received an interesting solicitation (please, don't quote-mine that). To remind you of…

I've written a number of times about how a physician must be careful not impose his or her personal beliefs on patients. Another interesting case has hit the news. The decision of the California Supreme Court hinged on interpretation of state non-discrimination law. I'm not a lawyer, but I do know a bit about medicine and medical ethics. Regardless of law, this doctor's behavior was wrong. The details are a little sketchy, but an unmarried lesbian woman was denied fertility treatments by a California doctor because the treatment conflicted with the doctor's faith. Conflicted with the…

The discussion we've had since Friday regarding the Bush administration's latest foray into theocracy brought up some interesting points. We discussed implications of the draft regulations including likely limitations on access to safe and effective birth control. But there is another issue here that disturbs me greatly. Last week we talked a little bit about medical ethics. I'm not an Ethicist (Mike! Are you reading?), but I am a "practical ethicist", as are all health care providers. How do ethics inform the discussion of what care we can or cannot provide? First, let's take the…

What could be more important than a good old-fashioned flame war? I'll get to that in a moment, so please stick with me. The recent imbroglio between some of our doctor bloggers and non-physician scientists got me thinking (so it couldn't be all bad). As a quick summary, PhysioProf of the DrugMonkey blog used an incident of a doctor committing battery on a patient as a generalization regarding surgeons, all doctors, and medical education. Many of us who are actually doctors and physician educators took issue with that. PhysioProf apologized, but made it clear that s/he still feels that…