Archive for the ‘Medicine’ Category
November 1, 2012
I have posted earlier about the disturbing ethical questions with the “Care Pathways” in the UK which operate in the grey zone between euthanasia and execution.
But it is more than just disturbing when UK hospitals run by NHS trusts apparently get financial benefits if they increase the number of terminally-ill patients who are put onto the so-called “Care Pathways”. Once someone is “put on a Care Pathway” they are effectively written off. Medication may be withdrawn, water and food may be withheld and any chance of continuing to live or of any recovery are removed – intentionally – from the equation. “Care” is provided but now with the intention of causing death. The sooner such patients die the better the use of resources!
I cannot see how any “Care Pathway” where there is an incentive to ensure that a patient dies and dies quickly can be anything other than an intentional termination of life. But is it euthanasia or is it murder or is it an execution?
Where the patient truly wishes to die it is effectively euthanasia. But where the patient would wish to live if he could only get better we get into a dangerous zone between euthanasia and execution. Can all attempts to “make the patient better” be abandoned by a hospital because someone other than the patient has decided that the patient cannot get better? When it is relatives who are pushing to get the patient onto a “Care Pathway” it comes close to murder. And when it is the hospitals or the hospital staff who are “incentivised” to get the patient onto the “Care Pathway” it gets close to being an execution. The decision to put someone onto a “Care Pathway” is itself then an irrevocable sentence of death. Why not – having passed sentence – just give them a quick, quiet lethal injection after putting them on a “Care Pathway”? Why go through the charade of care while ensuring the patients rapid demise? The 33 hours these patients survive on average after being put on a “Care Pathway” could be reduced to zero. Why not provide incentives to hospitals to
- maximise the number of patients put onto a “Care Pathway”, and then
- minimise the amount of time spent on such a Pathway?
This could get rid of many hundreds – if not thousands – of problematic and elderly patients who only absorb resources, no longer provide any useful contribution to society and are just a pain for their relatives. It would not be a very large step to converting the corpses to Soylent Green.
The Telegraph:
The majority of hospitals in England are being given financial rewards for placing terminally-ill patients on a controversial “pathway” to death…
Almost two thirds of NHS trusts using the Liverpool Care Pathway have received payouts totalling millions of pounds for hitting targets related to its use, research for The Daily Telegraph shows.
The figures, obtained under the Freedom of Information Act, reveal the full scale of financial inducements for the first time.
They suggest that about 85 per cent of trusts have now adopted the regime, which can involve the removal of hydration and nutrition from dying patients.
More than six out of 10 of those trusts – just over half of the total – have received or are due to receive financial rewards for doing so amounting to at least £12million.
At many hospitals more than 50 per cent of all patients who died had been placed on the pathway and in one case the proportion of forseeable deaths on the pathway was almost nine out of 10.
Last night the Department of Health insisted that the payments could help ensure that people were “treated with dignity in their final days and hours”.
But opponents described it as “absolutely shocking” that hospitals could be paid to employ potentially “lethal” treatments. ……
Tags:Care Pathway, Euthanasia, execution, Liverpool Care Pathway for the dying patient, murder, NHS, NHS trust
Posted in Behaviour, Ethics, Medicine, UK | 2 Comments »
October 17, 2012
An article in The Telegraph caught my eye while watching the US Presidential debate at my hotel.
A rather disturbing development in the UK and I don’t like the ethics of the situation. Euthanasia is voluntary but I am not sure that the Liverpool Care Pathway is. It is a pathway which leads to the death of the patient /victim in about 33 hours. I wonder who this pathway serves? At first sight it seems to be primarily for the benefit of hospitals and doctors and health care system costs. Perhaps for relatives.
The Telegraph:
Mary Cooper, 79, died a few days after being put on the Liverpool Care Pathway at the Queen Elizabeth Hospital in King’s Lynn, Norfolk.
The pathway, originally designed to ease the suffering of terminally ill cancer patients in their very last days, is being used more and more widely in NHS hospitals.
The idea behind the LCP is to give patients a ‘good death’ by avoiding unnecessary and burdensome medical interventions.
However, there have been accusations it hastens death because it can involve the removal of hydration and nutrition.
The LCP leads over 100,000 people to death every year – just in the UK. It smacks of execution of the elderly for convenience.
Daily Mail:
There are around 450,000 deaths in Britain each year of people who are in hospital or under NHS care. Around 29 per cent – 130,000 – are of patients who were on the LCP. …. Professor Pullicino claimed that far too often elderly patients who could live longer are placed on the LCP and it had now become an ‘assisted death pathway rather than a care pathway’.
An assisted death for someone who does not wish to die is an execution.
Tags:ethics, Euthanasia, execution of the elderly, Liverpool Care Pathway, National Health Service
Posted in Behaviour, Ethics, Medicine, UK | 3 Comments »
September 29, 2012
I have the most wonderful memories of my time as a post-doc at University College Cardiff in the mid-70’s. This was where I was educated into the intricacies of the rules of rugby and the tribal rituals surrounding the game. Pubs and real ale and rugby grounds and rugby songs and – of course – Max Boyce.
So I was a little sad to read about the strange goings-on at the laboratory of the Dean of Medicine at what is now Cardiff University. Lots and lots and lots of papers published by the Dean, Professor B P Morgan, (172 papers and 35 review articles or chapters since 1998 – giving 207 publications in about 180 months!) and now a retraction and a formal investigation into apparent image manipulation and duplication. A case of
“There were all those doctor’s papers and they all said just the same”
(with apologies to Max Boyce and his great lyrics to “We all had Doctor’s papers”)
THES:
Cardiff University has confirmed that it is to launch a formal investigation into alleged research misconduct in the laboratory of its dean of medicine.
(more…)
Tags:Cardiff Dean of Medicine, Cardiff University, Max Boyce, Prof B P Morgan, Rugby songs, Scientific misconduct, University College Cardiff, We all had doctors papers
Posted in Academic misconduct, Medicine, scientific misconduct | 1 Comment »
September 15, 2012
Belgium allows euthanasia under very stringent conditions and now permits prisoners also to choose euthanasia.
If you agree with the concept of euthanasia then the idea of allowing prisoners to opt for euthanasia would seem perfectly rational. There are ethical questions here which I am still thinking my way through but I think there are some dilemmas to be faced. However I cannot help feeling that a prisoner – almost by definition – is inevitably subject to some level of coercion. Within an isolated and vulnerable prison population where individuals are probably subject to the additional pressures of group phobias and pressure, I am not sure that an apparently voluntary choice can ever be a completely free choice.
And I have an additional dimension of nagging concern when organs for transplantation are harvested from euthanasia subjects:
BioEdge reports:
For the first time, a Belgian prisoner has been euthanased. A man identified as Frank V.D.B, who had spent 20 years in prison for two murders and rapes, died recently. The date is not clear from media reports, but it took place outside the prison. The death only became known because it was revealed by a politician, Senator Louis Ide, who was complaining about the lack of social services in Belgian jails. He seems to have been tipped off by a prison official.
The case has provoked a controversy in the media –not over euthanasia but over the violation of the prisoner’s right to privacy. All of the conditions for euthanasia in Belgium were carefully fulfilled: the prisoner had a terminal illness, he had made repeated requests for death, and three doctors had independently ratified the request. …..
Last year Belgian surgeons revealed that they had been harvesting organs obtained from persons who had requested euthanasia.
Tags:Belgium, Euthanasia, euthanasia for prisoners, Prison, Right to die
Posted in Behaviour, Ethics, Medicine | Comments Off on Belgium introduces euthanasia for prisoners
March 27, 2012
The kind of study results I thoroughly approve of and would like to believe!!
If only I was also convinced that it was entirely unbiased. It sounds like one of those studies which, if it had shown that chocolate was poisonous, would somehow have not been published.
A new paper in Archives of Internal Medicine:
Association Between More Frequent Chocolate Consumption and Lower Body Mass Index Beatrice A. Golomb, MD, PhD; Sabrina Koperski, BS; Halbert L. White, PhD Arch Intern Med. 2012;172(6):519-521. doi:10.1001/archinternmed.2011.2100
(more…)
Tags:Archives of Internal Medicine, BMI, Body mass index, chocolate
Posted in Medicine, Trivia | Comments Off on Frequent eating of chocolate (any amount) keeps you thin
March 23, 2012
There has been a debate going on in Sweden over the last few days as to whether surrogate motherhood should be permitted. In following the various views I cannot help feeling that a fundamental ethical consideration is being avoided – perhaps intentionally. The Swedish Parliament’s Social Affairs Committee voted by a large – and very politically correct – majority to carry out an investigation into whether Swedish surrogacy laws should be changed.
The Local: Sweden took a step toward a possible lifting of its ban on surrogate motherhood on Tuesday, despite impassioned opposition from political parties on both the left and right.
The Riksdag’s Committee on Social Affairs voted by a wide majority on Tuesday to authorize the government to carry out an inquiry into surrogate motherhood.
Currently, surrogate motherhood is outlawed in Sweden.
However, the Christian Democrats and the Left Party both opposed the measure.
“The issue of childlessness shouldn’t be solved by having women’s bodies used to carry and give birth to children for other people. Women’s bodies aren’t a commodity,” the Left Party’s Eva Olofsson told the TT news agency.
Even if surrogate motherhood is allowed on a non-commercial basis, there is nevertheless a risk for a black market trade in surrogate births, argued Olofsson.
She said that legalizing surrogate motherhood would send a signal that would increase acceptance of the practice that would open the door to trade with surrogate mothers in other countries, citing India as an example.
“It’s possible that we need more regulations that would make it so that it’s not allowed in Sweden to buy a child that has been born this way in India. But that’s not how the proposal looks,” said Olofsson.
With all new medical procedures I think the fundamental ethical requirement is the informed consent of all those involved. And for surrogacy that includes the child-to-be. But much of the debate about surrogacy laws in Sweden has been focused on the “rights” of women or the gay community to have children (or not). There is more concern for the “convenience” of these groups rather than for the welfare of the would-be child. Of course the “informed consent” of the would-be child is not available. But it should not be beyond the wit of man to consider the views the child would have – if it could. (more…)
Tags:Convenience of the parent, ethics of convenience, India, LGBT parenting, Surrogacy, Sweden
Posted in Behaviour, Ethics, India, Medicine, Sweden | Comments Off on Surrogate motherhood: The ethics of convenience
March 13, 2012
In December I posted about the suspicious goings on at Kyoto Prefectural University:
A Japanese investigative website (http://blog.m3.com/Retraction/) has found 12 published articles where manipulation of images is very likely. The suspicious images in the papers published by the Matsubara lab are carefully deconstructed by Abnormal Science in an ongoing series of posts: here, here and here.
Today Retraction Watch reports that the efforts of M3 (now discontinued) and Abnormal Science have not gone unnoticed:
The American Heart Association, which publishes a number of journals, has issued an Expression of Concern about five papers in three of their publications, following allegations of image manipulation. All of the papers include Hiroaki Matsubara, of Kyoto Prefectural University, as a co-author.
The notice begins:
It has come to the attention of the American Heart Association (AHA), in a public manner, that there are questions concerning a number of figures in several AHA journals’ articles…
The “public manner” was three posts last year on the Abnormal Science blog… alleging that images were manipulated in the manuscripts, and that histology slides were reused.
The notice continues:
After reviewing these concerns, we have asked the institution, Kyoto Prefectural University of Medicine, to investigate the allegations. Until we learn the outcome, we feel it is best to post this Expression of Concern to alert our readers that concerns about these articles have been raised.
Tags:Abnormal Science, American Heart Association, Blog-M3, Hiroaki Matsubara, image manipulation, Kyoto Prefectural University, Retraction Watch
Posted in Academic misconduct, Japan, Medicine, scientific misconduct | Comments Off on Update on Matsubara
February 25, 2012
Joerg Zwirner has been following this for some time at his AbnormalScience blog. Retraction Watch also posted about this. But it has now reached the ORI and even the main-stream media.
Yet another case of a Person of Indian Origin (PIO), Dr. Bharat B Aggarwal of the MD Anderson Cancer Center, being suspected of massive scientific misconduct this time at the University of Texas. Apparently 65 papers are being reviewed for the manipulation of images.
Deccan Herald:
A prominent Indian-American researcher at (the) University of Texas is under scanner for alleged falsification and fabrication in various publications regarding cancer fighting properties of plants.
(more…)
Tags:Abnormal Science, Bharat B Aggarwal, image manipulation, M D Anderson Cancer Center, ORI, Scientific misconduct, University of Texas at Austin
Posted in Academic misconduct, Medicine, Science, scientific misconduct | Comments Off on Prominent Indian-American researcher being investigated at the University of Texas
January 5, 2012
(Reuters) – Unreported data from early trials of experimental medicines in humans can result in harm to future patients and needless costs for health systems, according to scientists writing in the British Medical Journal on Wednesday.
The role of statistics in research leads to obvious risks for the drawing of conclusions about causal relationships between parameters without actually increasing the understanding about the underlying mechanisms. In pharmaceutical and health research such conclusions provide enormous financial benefits for the researchers and their sponsors – and not always in the interests of the patients involved.
(more…)
Tags:BMJ, British Medical Journal, Clinical trial, Pharmaceutical industry, Research, unreported data
Posted in Medicine, Research, Science | Comments Off on The data, all the data and nothing but the data
The k2p blog 