BILL OF HEALTH; HARVARD LAW SCHOOL: Laws and social policies not only shape health in a given society, but also go a long way in determining which populations and communities have relative health gains/losses. The absence of critically needed public health laws or a “public health law vacuum,” has, and continues to have, devastating consequences in the COVID-19 pandemic. Daniel Goldberg, JD, PhD illustrates how the federal government could have done and still could do to regulate in the name of public health emergency response (and preparedness for the future).
SURVEY PRACTICE: A national survey by Eric Campbell, PhD and co-authors asked oncologists about views regarding Medicinal Cannabis' (MC) risks/benefits, and whether they had sufficient knowledge to make MC recommendations clinically. Testing of the survey instrument suggested that physicians did not always feel that they possessed adequate MC knowledge in all domains, so Don't Know options were added to six of 27 survey items. The DKs appear to be valid responses, improving data quality by providing some respondents with an answer category that best fits their “true” answer.
BOULDER WEEKLY: Center Director Matthew Wynia, MD, MPH reflects, “I don’t think many people thought that we would do so poorly as a society in coming together around this pandemic and around a coherent response. Our assumption was that the national leadership would come together around this, like in a war or after 9/11. This is not just about the pandemic, it goes outside of bioethics and into social ethics, and is something we’re going to be grappling with as a society for a long time.”
CGTN AMERICA: Constructing an equitable system and determining in what order people should get the vaccine has sparked some debate, which often boils down to: “Who deserves this rather than where can it do the most good,” said Center Director Dr. Matthew Wynia. “This means balancing the most high-risk folks and those who are most responsible for transmission, like prisoners. People who are in circumstances where they can’t help but spread it to a whole bunch of other people because then you could avoid these super-spreader events.”
ETHICS AND HUMAN RESEARCH: A research participant’s right to withdraw from all research procedures is widely accepted, but there can be justifiable limits to a participant’s exercise of autonomy to withdraw from some procedures. Clinical outcomes trials depend on complete subject follow-up for accurate assessment of the safety and efficacy of investigational therapies. Warren Capell, Matthew Wynia and co-authors argue that a consent process that prospectively informs participants of mandatory passive follow-up is ethically justified and optimizes the balance between autonomy and beneficence.
USA TODAY: David J. Skorton and Lisa Howley wrote an opinion article about the monograph, "The Fundamental Role of the Arts and Humanities in Medical Education," recently issued by the AAMC, with the objective to improve the education, practice, and well-being of physicians through deeper integrative experiences with the arts and humanities. Tess Jones, PhD, was a member of the Arts and Humanities Integration Committee, which guided and shaped the concepts in this report.
THE HASTINGS CENTER: This “ethical framework,” aims to help structure time-sensitive discussion of emerging ethical challenges in the middle-tier distribution of Covid-19 vaccines. Matthew Wynia, Jean Abbott and co-authors developed guidance to support equity in response to vaccine hesitancy, prioritization of health care workers and health justice concerns that integrate clinical, organizational, and public policy initiatives to uproot social inequalities that produce health inequities.
COLORADO MAGAZINE-HISTORY COLORADO: Brian Jackson, MD, MA, writes, "The pandemic has exposed public health shortcomings and deadly racial inequities, propelling new ways of thinking about the health and wellbeing of our whole society, including what a “right to health care” really means. We’ve realized that a fair process for deciding how to respond might be more important than the response itself."
HUMAN RIGHTS WATCH: The US Migrant Protection Protocols Program (MPP) subjects children and adults to serious, ongoing harm, including abduction and rape, and should be quickly and decisively dismantled, according to a 103-page investigative report, "Like I'm Drowning," co-authored by Warren Binford, JD, EdM. She concludes, “The MPP was crafted and carried out by US government officials who knew or should have known they were putting children in harm’s way.”
AMA JOURNAL OF ETHICS: In this video edition of Ethics Talk, journal editor in chief, Dr Audiey Kao, talks with Dr. Matthew Wynia about implementation of crisis standards of care in response to the dramatic surge in COVID-19 cases that is pushing the limits of US hospitals' critical care capacity.
JOURNAL OF PAIN AND SYMPTOM MANAGEMENT: Jean Abbott, MD, MH, and co-authors review state and regional gaps in planning for scarcity in palliative care and hospice services during this pandemic and describe the initiatives Colorado has developed to address potential scarcities for this vulnerable and diverse group of people. They conclude that advance planning will help decrease stress on individual patients and families by helping patients, families, and their medical providers understand a patient’s wishes. On a community level, anticipation of potential needs if crisis standards of care must be activated, will decrease stress on healthcare systems by removing the burden of making allocation decisions at the bedside.
BRITISH JOURNAL OF CLINICAL PHARMACOLOGY: Drug and Therapeutics Committees make important decisions about which medicines are approved for use in hospitals, health systems and reimbursed by insurers. Lisa Bero, PhD and co-authors examine the potential influence of conflicts of interest of committee members on these decisions and makes suggestions for minimizing this influence and keeping the decisions based on evidence.
AMA JOURNAL OF ETHICS: This month's Journal is dedicated entirely to contemporary lessons to be learned from health professional involvement in the Holocaust. From abortion to xeno-transplantation, deliberation on almost every ethics topic in health care today—genetics, informed consent, public health, military and civilian health policy and practice, death and dying, human subjects research, and refugee care—is influenced by Nazi medical crimes. Matthew Wynia and Tessa Chelouche were co-editors and there are multiple articles featuring faculty and associates of the Center.
ATLANTA JOURNAL CONSTITUTION: Christine Baugh, PhD, MPH, and her co-authors surveyed 296 college football players from four teams in the Power 5 Conferences of the NCAA. They concluded, “That athletes underestimated their risk of concussion and injury in this study raises important ethical considerations. What is the threshold for college athletes to be sufficiently informed of the risks and benefits of football to make decisions that align with their values and preferences?”
PBS/WHYY-The Pulse: My mom saved my life that day. But what if she hadn’t been there? What if they didn’t catch it at all? I could’ve ended up permanently disabled. Or worse — I could have died. How come everybody but my mom dismissed my symptoms?
Center Director Matthew Wynia finds 22-year old Mimi Hayes quite inspiring - stroke survivor, comedian and now a budding journalist. She called to talk about medical errors and ethics...
SCIENTIFIC AMERICAN: A recent study by public health scientists at Deakin University in Australia, found that more than half of 1,461 studies yielded outcomes favorable to company products compared to less than 10 percent lacking such support. Commenting on the recent analysis, Lisa Bero, PhD, contends that industry may skew research in ways peer review cannot catch. She cites four key approaches industry uses to manipulate research: by influencing what research questions are asked, how studies are designed, how conclusions interpret data and whether unfavorable findings ever get published.
NATIONAL ACADEMY OF MEDICINE: Months into the pandemic, there’s no reliable estimate of health care worker deaths due to COVID-19. A new rapid expert consultation, co-authored by Center Director Matthew Wynia, MD, MPH, proposes methods to track deaths from occupational exposure to the virus, and deaths by suicide. It also outlines strategies to support the physical safety and mental well-being of health care workers
NEWSWEEK: Over the past four years, only a small handful of private citizens have been granted access to US government facilities to interview children and their families arriving in the United States and check if their conditions are safe, sanitary and appropriate. CBH faculty Warren Binford, JD, EdM and attorney Hope Frye were two of those citizens. In trips to over a dozen facilities and interviews with over 100 children and their families, they exposed hunger, filth, coldness, illness and shame these children have endured at the hands of the U.S. government.
LAWS: The creation and distribution of child sexual abuse material (CSAM) has become one of the fastest growing illicit online industries in the United States. Warren Binford, JD, EdM and co-authors conducted interviews and focus groups with law enforcement agencies and legal representatives throughout the western United States, to understand challenges and complexities of investigating and prosecuting cases of CSAM, and as a foundation to develop best practices in this area.
SOCIAL SCIENCE AND MEDICINE: When health recommendations significantly differ from, or threaten the interests, values and preferred practices of end-users, organized and often very public resistance to guideline implementation may result. Lisa Bero, PhD and co-authors explore why professional stakeholders form active resistances to the implementation of some clinical guidelines, and how professional values, perspectives, interests and/or experiences influence the stakeholders’ stance. The authors suggest strategies to mitigate and resolve these issues, including understanding resistance as a political strategy, increasing transparency of public input and coalition building as a part of the public response to active resistance