THE HASTINGS CENTER: Congratulations to Professor Eric G. Campbell! Hastings Center Fellows are academic bioethicists, scholars from other disciplines, scientists, journalists, lawyers, novelists, artists or highly accomplished persons from other spheres. Their common distinguishing feature is uncommon insight and impact in areas of critical concern to the Center – how best to understand and manage the inevitable values questions, moral uncertainties and societal effects that arise as a consequence of advances in the life sciences, the need to improve health and health care for people of all ages, and mitigation of human impact on the natural world.
THE COLORADO SUN: Matthew Wynia, MD, MPH explains, If you are looking like you’re about to have to do triage, you should be implementing these strategies in advance. Not withholding services, but you should pull your triage team together in advance; you should be creating the load balancing mechanisms across systems. And that really has to be done at the state level. No single hospital has the capacity to do that. And the biggest ethical failure is if you’ve got a doctor in one hospital saying, “I’m sorry, I don’t have an ICU bed for you” and you end up having to die because you can’t get the intensive care that you need when there was an ICU bed available but it was six miles away at a different hospital.
CENTER FOR PUBLIC INTEGRITY: Center Director, Matthew Wynia, MD, MPH, says individual doctors should not have to decide who might receive certain resources when they may not be as focused on how many resources are available more broadly. “You want the doctor at the bedside to be able to serve as the advocate for their patient,” Wynia said. “You don’t want them being the judge deciding between their patients.”
THE DENVER GAZETTE: "Basically, it's a matter of transplantable organs are very scarce, we don't have enough of them for everyone who needs them and want to give them to folks who are going to have the best chance of getting the most years of use out of that organ," said Matthew Wynia, MD, MPH. "If someone puts that organ at risk, you'd rather give it to someone else."
JOINT COMMISSION JOURNAL ON QUALITY AND PATIENT SAFETY: Two articles focusing on disability, authored by CBH faculty were published in the October, 2021 edition.
1) Use of Accessible Weight Scales and Examination Tables/Chairs for Patients with Significant Mobility Limitations by Physicians Nationwide, by Eric Campbell and Julie Ressalam and 2) Implementation of Collection of Patients’ Disability Status by Centralized Scheduling, by Megan A. Morris.
AMERICAN ASSOCIATION FOR PHYSICIAN LEADERSHIP: Interview with Dr. Matthew Wynia on a range of topics around the pandemic, including the need to improve systems of care to avoid medical errors, and to consider applying that same lens to address racial and socio-economic disparities in health care.
AP NEWS: Center Director, Dr. Matthew Wynia, said state authorities should be responsible for establishing strategies needed to make triage decision fairly, so doctors and nurses aren’t left making those calls on their own at a patient’s bedside. “There’s no way to look at this and say this is OK. It’s not OK,” he said. But it’s necessary if hospitals are running out of resources, “which is happening right now.’’
HONOLULU CIVIL BEAT: Matthew Wynia, MD, MPH, Director of the Center for Bioethics and Humanities said, Hawaii’s plan is very similar to other states and largely uses boilerplate language, but is unusual in how it explicitly describes age and life cycle considerations as determinants. “I see a problem with having an explicit age cut off,” he said. “There’s really very little to differentiate a 64-year-old from a 65-year-old.”
BOISE STATE PUBLIC RADIO NEWS: Center Director Matthew Wynia explains, If you talk to anyone in the health care system who sees the current wave of infections and death as being avoidable. And so, there is an enormous amount of anger. There's even anger across states. You know, if you go to the ICUs in Colorado right now, my colleagues in the ICU are fielding 30, 40 calls a day from out of state hospitals seeking to transfer patients to us. And I have to say, there are people in our ICUs that are starting to say, really, you know, ”We're pretty full right now. Is it our responsibility to bail out the states that are not doing what they need to do to keep community transmission rates low?”
PEDIATRIC OBESITY: It is estimated that 13.7 million US paediatric patients have obesity and 6% have severe obesity. These conditions can decrease life expectancy by 2 to 20 years. Evidence suggests that metabolic and bariatric surgery (MBS) is the most effective and durable treatment for severe obesity and complications of obesity in both adults and adolescents. However MBS remains underutilized with prior estimates suggesting that less than 1% of eligible paediatric patients undergo MBS. In this study, authors Sarah Ogle, Julie Ressalam, Christine Baugh, Eric Campbell, Megan Kelsey and Thomas Inge describe the demographic, medical comorbidity and insurance status of eligible, referred and receivers of MBS at a freestanding academic children's hospital with dedicated weight management and MBS programmes as an initial exploration of extent that referral acts as a barrier to MBS. Secondly, they explored predictors that may influence referral for MBS.
PATCH: Bucks County, PA Free Library Celebrates National Hispanic Heritage Month from September 15-October 15, by featuring "Eschucha Mi Voz." Written in both Spanish and English, this book by Warren Binford, JD, PhD, tells the stories of children detained at the US-Mexico border.
VOICE OF AMERICA: Warren Binford, a law professor at the University of Colorado, was part of a remote, entirely digital network of volunteers who, she estimates, assisted 1,400 Afghans in getting out. "The State Department had been put in charge of an evacuation from a warzone," she said, contending that as a result the military did not have the full command of the operation. They learned to "pivot and adapt on a constant ongoing basis", she said.
WALL STREET JOURNAL: “It’s total chaos,” said Warren Binford, a law professor at the Center for Bioethics and Humanities who has been working on evacuation efforts. “What’s happening is that we’re seeing a massive underground railroad operation where, instead of running for decades, it’s literally running for a matter of hours, or days.”
THE HASTINGS CENTER: This question sparked debate recently after the leak of an internal memo of the North Texas Mass Critical Care Guideline Task Force, that proposed using patients’ Covid-19 vaccination status as a factor to assign intensive care beds. Matthew Wynia, MD, MPH, and co-authors conclude that with surges occurring across the U.S. and in many other countries, it is tempting to blame individuals who prefer not to be vaccinated despite vaccine access. But using vaccination status as a first-order triage consideration is not clinically justified at present, since it should not be assumed that vaccinated patients have a survival advantage once they require mechanical ventilation, at least until more information is available.
NATIONAL ACADEMY OF MEDICINE: One of many recommendations by Matthew Wynia, MD, MPH and co-authors is that specialty societies, major health care systems, public health departments and officials, and private sector health information technology partners should work together to leverage AI to assist in developing better prognostic tools for critical illness in general, as well as for disease- and injury-specific situations, and to develop systems for tracking the effects of using these algorithms on key measures of equity.
BRITISH MEDICAL JOURNAL: Lisa Bero, PhD and co-authors found that the pharmaceutical industry contributes considerable funding to the fertility sector and conclude that the conflicts of interest created by these payments, together with the commercial influences associated with the private model of service provision, are likely to contribute to the overuse of fertility services.
DISABILITY EQUITY COLLABORATIVE: "The DEC Research workgroup conducted this study during the COVID-19 pandemic—making the work considerably more challenging,” said CBH faculty Dr. Megan Morris. “However, it also created an important opportunity to shine a bright light on the gaps in health care accessibility for people with disabilities."
CHALKBEAT COLORADO: "A common misconception is that because the vaccines are currently under an emergency use authorization, that they are experimental, which is false," said Daniel Goldberg, JD, PhD. “If it’s gone through the process to get emergency use authorization, it is an approved intervention. In terms of the amount of data that we have, these are the most evaluated therapies we’ve ever used anywhere."
FOX31 DENVER: Many people have asked: Is it legal for employers or the government to require the shots? Center Director Matthew Wynia, MD, MPH says, “The answer to your question, are vaccination mandates legal, is yes. They are clearly legal under U.S. law and under the U.S. Constitution, and that has been litigated repeatedly and essentially always comes up with the same answer.” He said things have been that way since the early 1900s, when the U.S. Supreme Court upheld smallpox vaccine mandates.