Ethics

Physician-assisted Suicide – Is Now the Time?

April 24, 2010
Physician-assisted Suicide – Is Now the Time?

Juliana Eng MD

Several months ago, the U.K. courts ordered Ken Starmer, Director of Public Prosecutions, to delineate the conditions under which his office would be likely or unlikely to prosecute people who helped friends or relatives kill themselves.  This list of conditions is intended to provide information so that those who wish to assist another commit suicide can make an informed decision.  Yet Section 2(1) of the Suicide Act of 1961 provides: “A person who aids, abets, counsels or procures…

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The Ethics of Electronic Health Records

January 15, 2010
The Ethics of Electronic Health Records

John J. Mercuri

Faculty peer reviewed

Introduction
The 111th Congress allocated $19 billion of the American Recovery and Reinvestment Act of 2009 toward the creation of an electronic health record (EHR) for each person in the United States by 2014.(1) The recent debate over EHRs has focused largely on the economic, logistical, and political consequences of implementing such a system; however, the country should also contemplate the ethical ramifications of EHRs. Addressing…

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Ethics Commentary: Communication and Breaking Bad News

July 2, 2009
Ethics Commentary: Communication and Breaking Bad News

Commentary on Dr. Cox’s Tales of Survival by Antonella Surbone MD PhD FACP, Ethics Editor

Commenting on Dr. Cox’s honest heartfelt piece is not an easy task and even less so for me, as Ethics Editor. Why? Because before being a trained, published bioethicist, I’m a physician too. I’ve been through medical training and Fellowship in oncology in Italy and in the US: everywhere I have experienced the same doubts and felt the same anguish that Dr. Cox powerfully describes. During my internship,…

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Commentary on Conscientious Objection in Medicine: A Moral Dilemma

June 5, 2009
Commentary on Conscientious Objection in Medicine: A Moral Dilemma

The following is a commentary  on last week’s post, Conscientious Objection in Medicine: A Moral Dilemma, written by Dr. Bradley.

 Commentary by Antonella Surbone, MD PhD FACP, Ethics Editor

The piece by Dr. Bradley raises a highly controversial issue in today’s medicine, physicians’ conscientious objection. Dr. Bradley reviews recent legislature, as well as medical literature, including the underlying ethical argumentation. Unfortunately, the key issue of ethical and moral justification for conscientious objection in medicine is…

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Conscientious Objection in Medicine: A Moral Dilemma

May 28, 2009
Conscientious Objection in Medicine: A Moral Dilemma

Ishmeal Bradley MD

Faculty Peer Reviewed

Please also see the commentary by Antonella Surbone, MD PhD FACP, Ethics Editor

Consider this: what would you do if a patient with terminal pancreatic cancer told you, his primary care doctor of twenty years, that he wanted your help to end his life? Or, what if a woman in her first trimester who contracted an infection that threatened the health of her fetus asked you, her obstetrician, to perform an…

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Is prescribing placebos an ethical practice?

February 18, 2009
Is prescribing placebos an ethical practice?

Commentary by Antonella Surbone, MD PhD FACP, NYU Department of Medicine, Clinical Correlations Ethics Section Editor

In October 2008, BMJ published a research article entitled “Prescribing placebo treatments: results of a national survey of US internists and rheumatologists.” Of 679 physicians who responded to a cross sectional mailed survey, over 50% reported having prescribed placebos on a regular basis. Placebos included varied from saline (3%), sugar pills (2%), OTC analgesics (41%), vitamins (38%), antibiotics (13%) and sedatives (13%). According to the authors’ definition, the placebo…

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X-Ray Visions: What is your radiation risk?

January 29, 2009
X-Ray Visions: What is your radiation risk?

Commentary by Michael Hanley MD PGY-3 and James D. Koonce MD PGY-3, Department of Radiology, Medical University of South Carolina

www.X-rayRisk.com - A Free Online Calculator that Estimates an Individual’s Additional Risk of Cancer as a Result of Medical Imaging

An estimated 62 million CT scans are obtained in the United States each year.(1) While debated, a recent study suggests that radiation exposure from medical imaging may be responsible for 1-3% of cancers worldwide.(2) With recent media coverage focusing on the risk of cancer from medical…

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The Genetic Information Nondiscrimination Act (GINA)

October 25, 2008
The Genetic Information Nondiscrimination Act (GINA)

Commentary by Bani Chander MD, PGY-3.  Reviewed by Antonella Surbone MD PhD FACP, Ethics Section Editor.

On May 21, 2008, president George W. Bush signed the Genetic Information Nondiscrimination Act (GINA) into effect. After 13 years of debate in Congress, the bill finally passed through both the senate and the house nearly unanimously. So what is GINA? This piece of legislation prohibits insurance companies from taking into account genetic conditions or family history when determining risk assessment. In addition, GINA makes it illegal for employers…

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Ethical Responsbilities After GINA

October 25, 2008

Commentary by Antonella Surbone, MD PhD FACP, Ethics Section Editor

The Genetic Information Nondiscrimination Act (GINA), passed by the US Congress on May 1st 2008, protects individuals against discrimination by health insurers and employers on the basis of genetic information.(1-4) Genetic information refers to genetic tests of a person’s or a family member up to fourth-degree relatives. Genetic test is any analysis to detect genotypes, genetic mutations or chromosomal changes, not including analysis of proteins or metabolites directly related to a manifested disease. Genetic information…

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Ethics Q&A

September 16, 2008
Ethics Q&A

Q: What is the appropriate response for an internist to the phone call from a friend….”I hate to ask you but,….I have this minor problem and could you help me over the phone or in your/my house?” Some of these friends are officially your patient, some are not. I have dealt with this twice already this week.

–Deborah Shapiro MD

A: Commentary by Antonella Surbone MD PhD FACP, NYU Department of Medicine, Ethics Section Editor

The issue of dealing with taking care of family and…

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Old age and frailty: Biology and Socio-cultural Constructs

August 21, 2008
Old age and frailty: Biology and Socio-cultural Constructs

Commentary by Antonella Surbone MD PhD FACP, Department of Medicine, New York University Medical School, Clinical Correlations Ethics Section Editor

According to the Institute of Medicine (IOM) report of April 14th, 2008, the elderly comprise 12% of the U.S. population, and their number is projected to almost double between 2005 and 2030, from 37 million to 70 million. The elderly currently account for more than one third of all hospital stays and of prescriptions, and more than a fourth of all office visits…

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Its okay to smoke…we’ll screen you

May 9, 2008
Its okay to smoke…we’ll screen you

Commentary by Shrujal Baxi MD, NYU Chief Resident

One of the first things you learn about critically analyzing a medical journal piece is to go to the end and see who sponsored the study. Corporate financing is known to have subtle effects on research which can lead to an unconscious bias. Disclosure of funding is paramount for a researcher in order to remain above reproach.

In a recent New York Times article, the impact of such relationships is investigated. In 2006, Dr.…

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