JOURNAL OF LAW, MEDICINE AND ETHICS: This Symposium Edition, edited by Daniel Goldberg, JD, PhD, explores the anxieties about feigned illness and the gaps in health and social policies spanning employment status, public benefits, disability accommodations, access to health care, occupational health, sports participation, child welfare and family policy, and veterans’ support in the United States. Professor Goldberg also contributed an essay and a video introduction to the publication.
MEDPAGE TODAY: Second Opinion by Matthew Wynia, MD, MPH. We cannot tolerate a profession where doctors clinging to disproven theories are killing patients. The purpose of professional self-regulation is to protect public safety -- that's it. When significant harms are arising due to a doctor's persistent and demonstrably false beliefs, good intentions and sincerity in holding the false beliefs no longer matter. The medical profession must sanction the COVID quacks.
BILL OF HEALTH: The field of health law makes as big a scholarly contribution outside the legal literature. Scott Burris, Director of the Center for Public Health Law Research at Temple University looked at citations beyond Westlaw, instead using Google Scholar. He found that Daniel Goldberg, JD, PhD ranked 11th nationwide in this list of the most cited law professors. Great work Daniel!
COLORADO PUBLIC RADIO: Carey Candrian, PhD, associate professor at the CU School of Medicine, studies how communication shapes — and is shaped by — perception, attitudes and biases in the LGBTQ+ community. She’s interviewed dozens of older adults from the community about their experiences with the healthcare system. It’s one thing to publish academic articles, speak at conferences for medical professionals or to lecture students, Candrian explained, and it’s another to use art to convey the humanity of the people behind the research.
Candrian decided to photograph 27 of the older LGBTQ+ women she’s interviewed over the last five years and then display those photos with quotes describing some of their thoughts and experiences, at the Fulginiti Pavilion. "They’ve been whispered about, shouted at, insulted, rejected, isolated. But here they are, strong and brave. Look into their eyes," the exhibit's description reads. Visit the exhibit webpage. Read article>>
THE BRITISH MEDICAL jOURNAL: Formula milk is consumed by most European and North American infants, and new formula products need to be tested in clinical trials. But concerns have been raised that formula trials are biased and could undermine breastfeeding. To explore this further, an international team of researchers set out to evaluate the conduct and reporting of formula milk trials. Lisa Bero, PhD and co-authors found the need for a substantial change in the conduct and reporting of formula trials to adequately protect participants from harm and protect consumers from misleading information.
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.