ORGANIZATION FOR DEFENDING VICTIMS OF VIOLENCE: As the international community finds itself fractured by conflicts, economic instability, pandemics, and the looming climate emergency, children are the ones who prove to be the most vulnerable. Iranian journalist Kourosh Ziabari interviews Warren Binford, JD, Ed.M.,, W.H. Lea for Justice Endowed Chair in Pediatric Law, Ethics & Policy, and Director for Pediatric Law, Ethics & Policy at the Kempe Center, about the key challenges to children’s rights and the most viable strategies to respond to them. Read article>>
BILL OF HEALTH-HARVARD LAW: Daniel Goldberg, JD, PhD argues that the premise of harm reduction rests on the idea that the perfect ought not be the enemy of the good. We live in a non-ideal world and public health interventions must be designed and implemented with such imperfections in mind.
Utopian ideals are important insofar as they frame the state of play between our current world and the destinations that we are trying to reach. However, the map is not the territory; clinging too much to a plan even when real-world conditions frustrate the ideal journey may leave travelers lost in the wilderness.
THE NATION: After 3.5 years of litigation, the DOJ has released video footage depicting the force-feeding of Mohammad Salameh, detained at ADX Florence, a federal prison in Colorado that houses one of the most secretive units in the United States. Salameh reports that he was force-fed more than 200 times over the course of his eight hunger strikes. The newly-released videos and an accompanying feature depict two instances of medical treatment forced on Salameh: one rehydration by IV and one feeding by nasogastric tube.
Matthew Wynia, MD, MPH, Director of the Center for Bioethics and Humanities and Advisor to Physicians for Human Rightssays there is no doubt that the Bureau of Prisons violated medical ethics and international law in providing forced medical treatment to Salameh. The force-feeding was conducted in a manner far outside of medical norms, causing significant discomfort to Salameh and potentially endangering his life.
5280 MAGAZINE: Carey Candrian, PhD, associate professor at CU School of Medicine, photographed older Colorado women who are a part of the LGBTQ community for her exhibit, Eye to Eye: Portraits of Pride, Strength, Beauty, which was displayed at the Fulginiti from October 2022-July 2021. The show is now on display at the Bob Ragland Branch Library in Denver.
"As academics, we get pressured to publish literature and write books, and I’ve done those things. None of them have had an impact as much as these photographs. I spend a lot of time thinking about how different things would be if we disseminated data in a way that was more accessible and in a way that could actually lead to change. Art is a really great way to change culture. It’s harder to hate someone to their face.”
"Doing research requires a certain level of trust between the researcher and the participants. The bravery and courage these women have shown has been phenomenal. They’ve been trained to stay silent, and then having to say yes to their photos and stories being on display throughout the entire state is a level of courage that I think is only made possible through that trust."
LA TIMES: Authors Wendy Netter Epstein and Daniel Goldberg warn that a direct consequence of ending the U.S. Public Health Emergency will be that uninsured and undocumented people won’t be able to access care for COVID. This is a tragedy in its own right and is likely to expand racial health inequalities connected to COVID. It will also have broader impacts on the community and the economy as COVID will spread, workforce shortages will continue and burdens of long COVID will increase.
They suggest States work to enact social policies that are likely to reduce COVID-related inequalities, such as paid sick leave laws, universal basic income requirements and supplemental nutrition assistance programs.
JOURNAL OF CLINICAL ETHICS: Author Kristin Furfari, MD, finds medical decision making for unrepresented patients is fraught with challenges, given the significant vulnerability of patients who are unable to make their own preferences known. At the 2022 Clinical Ethics Unconference in Atlanta, ethicists from different states and diverse healthcare institutions met to address the challenge and brainstorm approaches.
Furfari and Unconference participants concluded that the involvement of ethics committees is essential to support a thoughtful, transparent process in which diverse perspectives are recognized. Additionally, proxy decision makers should undergo bias education and cultural awareness training to minimize the potential contribution of harmful bias or stereotyping in the decision-making process.
HEALTH AFFAIRS: Daniel Goldberg, JD, PhD, and co-authors illustrate how laws and policies mediate structural stigma through the example of substance use disorder stigma; to explore potential mechanisms linking structural stigma in law to negative health outcomes, and therefore to health inequities for populations that are already marginalized; and to recommend an approach for revision of laws and policies that can significantly reduce structural stigma for targeted communities.
NATIONAL PUBLIC RADIO: It's been five months since Roe v. Wade was overturned, and now 13 states have laws banning abortion with limited exceptions for medical emergencies. Doctors who violate these laws could face felony charges, prison time and the loss of their medical license. There have been no reported prosecutions of health care workers, but Center Director Matthew Wynia, MD,MPH, says charges against doctors will certainly come. "There will be individual doctors who will get - presumably, will end up in court. And then, you know, the question will arise - were they supported? Can they be supported?"
KUNC ALL THINGS CONSIDERED: “Ragtime: The Mind and Music of Scott Joplin,” was performed by Juilliard-trained musician and Harvard-trained psychiatrist Dr. Richard Kogan at the Anschutz Campus on November 17th. KUNC's Michael Lyle sat down with Kogan to discuss how he weaves music and medicine together, and how Joplin's compositions serve as a way to explore issues such as racism and discrimination. Listen to the 5m interview>>
THE INTERCEPT: “If someone has capacity — they’re legally competent to make their own medical decisions — you cannot force-feed them,” said Matthew Wynia, MD, MPH, one of the expert reviewers of a research report by the ACLU and PHR titled Behind Closed Doors: Abuse and Retaliation Against Hunger Strikers in U.S. Immigration Detention, which spotlights ICE’s orders for involuntary and punitive treatment, including force-feeding, forced hydration, forced urinary catheterization, and other involuntary and invasive medical procedures. Wynia continues, "doctors do not have a place to use their skills and knowledge to be agents of the state for purposes of law enforcement, or for purposes of maintaining control of the prison population, or to try and break the hunger strike.”
HEALTHAFFAIRS FOREFRONT Mika Hamer, PhD, MPH and co-authors published a commentary about policy tools for securing long-term access to outpatient treatment for COVID-19 among uninsured and underinsured populations. They note the COVID-19 safety net was rapidly woven in the wake of a frightening worldwide pandemic. As time has passed, this safety net is unraveling. It is time to start putting it back together for an enduring effect.
The Department of Medicine Rising Star Award recognizes outstanding early-career faculty members who exemplify the department’s core values of excellence in patient care, research, education and community service. The 2022 Rising Star awardees are: Maheen Z. Abidi, MD, FAST, Division of Infectious Diseases, Kimberley D. Bruce, PhD, Division of Endocrinology, Metabolism and Diabetes, Matthew DeCamp, MD, PhD, Division of General Internal Medicine and Center for Bioethics and Humanities, and Joseph Alan Hippensteel, MD, MS, Division of Pulmonary Sciences and Critical Care Medicine. Congratulations Dr. DeCamp!!
The El Pomar Foundation recently recognized Pete Coors, chairman of the Molson Coors Beverage Company, and Marilyn Coors, PhD, associate professor emerita at the Center for Bioethics and Humanities, with the 2022 Ben S. Wendelken Trustee Award.
AMA JOURNAL OF ETHICS: In the discussion of waste and the health care system, co-authored Danielle Chaet, MSB, material waste (such as infectious waste, sharps, and general waste) is only one part of the ethical issue; the other part is the waste of health care resources. Currently, an estimated 25% of annual spending in the US health care industry is wasted. Physicians therefore ought to act collectively to advocate for reforms to the administrative and pricing structures of the health care industry so as to reduce this waste, ameliorate financial obstacles, and responsibly steward scarce resources in a way that best serves patient needs
NEJM PERSPECTIVE: What should medical professionals do when a law requires them to harm a patient? Center Director Matthew Wynia, MD, PhD, believes this question has become a pressing one as physicians grapple with the implications of state laws banning abortion. A thoughtful debate over whether and how to embark on a path of professional civil disobedience will take time and commitment. Physicians will need to bring specific proposals to their professional associations for ways to assist members who disobey unjust laws, including providing legal, financial, and social support. But I believe now is the time for these conversations to begin.
THE CONVERSATION: How do you know when a research study is reliable and evidence-based? And how can you tell the difference between shoddy research findings and those that have merit? Unreliable scientific studies can be hard to spot – whether by reviewers or the general public – but by asking the right questions, it can be done. Lisa Bero, PhD, has been studying bias in the design, conduct and publication of scientific research for 30 years, and has developed ways to prevent and detect research integrity problems so the best possible evidence can be synthesized and used for decisions about health.
Bero and colleagues recently published, Experts identified warning signs of fraudulent research: a qualitative study to inform a screening tool, in the Journal of Clinical Epidemiology, which found that it’s possible for researchers who review and synthesize evidence to create a checklist of warning signs, and use these warning signs to create a screening tool – a set of questions to ask about how a study is done and reported – that provides clues about whether a study is real or not.
LA TIMES: In this editorial, Wendy Netter Epstein, JD and Daniel Goldberg, JD, PhD state the the lack of a coordinated public health response deprioritizes community health and worsens longstanding health disparities. The CDC has issued tentative and confusing recommendations, leaving critical decisions to local communities and forcing individuals to turn to their healthcare providers. With school starting across the country, public health officials should set clear rules that guard public health as a goal bigger than any one person’s individual risk. And communities should come together to support them.
FAMILIES, SYSTEMS, & HEALTH: In this editorial, authors Sarah Hemeida and Daniel Goldberg assert stigma is an under-recognized health malady that is both rampant for vulnerable communities and difficult to measure for researchers. Stigma has enormous and compounding negative health impacts, associated with lower education levels, employment and income, and poorer control of chronic conditions and illness.
Stigmatizing laws against individuals with addiction have a powerful role in downstream health, including opportunities for employment, access to health insurance, self-stereotyping, and reduced willingness to access recovery resources.
In addition to traditional interventions such as peer supports, addiction counselors, and community-based rehabilitation programs, the legal determinants of health contributing to structural stigma against substance use disorder need to be addressed and corrected.
DENVER POST: Gender-affirming care is not child abuse say experts Warren Binford, JD, Ed.M and Mary Kelly Persyn, JD. At a time when political divisions and partisanship threaten to upend society, it is more important than ever to ensure that social policies are informed by research and evidence, not misinformation and hysteria, especially when it comes to children in their formative years. When transgender youth do not receive affirming love and care, they suffer. According to a survey just released by The Trevor Project, 94% of LGBTQ youth reported in 2022 that current political attacks were taking a toll on their mental health.
CU SCHOOL OF MEDICINE: Congratulations to our own Dr. Tess Jones for her selection by graduating medical students as the recipient of the President’s Excellence in Teaching Award. This is a remarkable and incredibly exclusive honor; to be selected by graduating students as the single most excellent teacher they’ve had during all of medical school is a tremendous demonstration of Tess's knowledge, skill, passion and energy. She serves as an inspiration to us all!