Category Archives: Ethics

Bill would require drug companies to report their payments to nurses and physician assistants


Twenty-dollar bill in a pill bottleBy Charles Ornstein ProPublica, Oct. 8, 2015, 11 a.m.
This story was co-published with NPR’s Shots blog.

A bill proposed Wednesday by two U.S. senators would require drugmakers and medical device manufacturers to publicly disclose their payments to nurse practitioners and physician assistants for promotional talks, consulting, meals and other interactions.

The legislation would close a loophole in the Physician Payment Sunshine Act, which requires companies to report such payments to doctors, dentists, chiropractors, optometrists and podiatrists.

Companies have so far released more than 15 million payment records, covering August 2013 to December 2014. Continue reading


California approves physician-assisted suicide; Bill heads to governor’s desk


Flag_of_CaliforniaBy APRIL DEMBOSKY

A controversial bill to legalize physician-assisted suicide in California is headed to the governor for consideration, after almost nine months of intense — often personal — debate in the legislature.

If Gov. Jerry Brown signs the bill, California would become the fifth state to allow doctors to prescribe lethal medication to terminally ill patients who request it, after Oregon, Washington, Vermont and Montana.


Seattle Children’s ethics conference now online (video)


The videos from Seattle Children’s Treuman Katz Center for Pediatric Bioethics 2015 Conference, The Delicate Triangle: Responsibilities and Challenges in the Provider-Patient-Parent Relationship, are now available on the Seattle Children’s website,

Here’s the opening talk, entitled “Must We Always Tell Children the Truth?”, by John Lantos, MD,, director of the Children’s Mercy Hospital Bioethics Center in Kansas City.


Pediatricians recommend individualized counseling for parents of extremely premature infants


Premature infant's tiny hand being held By Jenny Gold

For the tiniest infants — those born before 25 weeks in the womb — survival is never guaranteed, and those who make it may be left with severe disabilities.

These micro-preemies are born in what’s known as the “grey zone.”  Whether or not to resuscitate them depends on the decisions made by individual hospitals, doctors and parents. Decisions can vary greatly even among hospitals in the same area.

A new statement from the American Academy of Pediatrics aims to improve the way those decisions are made. The statement suggests that doctors individualize counseling for parents based on the particular baby’s chances of survival and the family’s goals for their child. Continue reading


Abortion foes dive in clinic dumpsters for discarded records


Dumpster-nonBy Charles Ornstein ProPublica
This story was co-published with NPR’s Shots blog.

The scene in front of abortion clinics is often tense, with clinic workers escorting patients past activists waving signs and taking photographs.

But increasingly, another drama is unfolding out back. There, abortion opponents dig through the trash in search of patient information.

Using garbage as their ammunition, anti-abortion activists who have sometimes been accused of violating abortion seekers’ privacy are turning the tables. They claim it’s the clinics that are violating patients’ privacy by discarding medical records in unsecured ways.

“Everybody acts like the abortion clinics are this bastion of protection for women’s privacy, and they’re like the chief offenders of just dumping this stuff willy-nilly,” said Cheryl Sullenger, senior policy advisor at Operation Rescue, an anti-abortion group based in Wichita, Kansas. “It’s so hypocritical.”

Abortion rights groups counter that while a small number of clinics have improperly disposed of records, the vast majority take strict precautions to protect patient privacy. It’s far more common, they say, for abortion opponents to trespass on private property or try to break into locked dumpsters.

PHOTONiteowlneils at the English language Wikipedia under Creative Commons license Continue reading


Racial gap in attitudes toward hospice care


By Sarah Varney

BUFFALO — Twice already Narseary and Vernal Harris have watched a son die. The first time — Paul, at age 26 — was agonizing and frenzied, his body tethered to a machine meant to keep him alive as his incurable sickle cell disease progressed.

When the same illness ravaged Solomon, at age 33, the Harrises reluctantly turned to hospice in the hope that his last days might somehow be less harrowing than his brother’s.

Their expectations were low. “They take your money,” Mrs. Harris said, describing what she had heard of hospice. “Your loved ones don’t see you anymore. You just go there and die.” Continue reading


Why your doctor won’t friend you on Facebook


like-thumb-facebookBy Shefali Luthra

Doctors’ practices are increasingly trying to reach their patients online. But don’t expect your doctor to “friend” you on Facebook – at least, not just yet.

Physicians generally draw a line: Public professional pages – focused on medicine, similar to those other businesses offer – are catching on. Some might email with patients.

But doctors aren’t ready to share vacation photos and other more intimate details with patients, or even to advise them on medication or treatment options via private chats.

They’re hesitant to blur the lines between personal lives and professional work and nervous about the privacy issues that could arise in discussing specific medical concerns on most Internet platforms.

Some of that may eventually change. One group, the American College of Obstetricians and Gynecologists, broke new ground this year in its latest social media guidelines. It declined to advise members against becoming Facebook friends, instead leaving it to physicians to decide.

“If the physician or health care provider trusts the relationships enough … we didn’t feel like it was appropriate to really try to outlaw that,” said Nathaniel DeNicola, an ob-gyn and clinical associate at the University of Pennsylvania, who helped write the ACOG guidelines. Continue reading


Medicare says doctors should get paid to discuss end-of-life issues


By Kristian Foden-Vencil, Oregon Public Broadcasting and Stephanie O’Neill, Southern California Public Radio

Remember the so-called death panels?

When Congress debated the Affordable Care Act in 2009, the legislation originally included a provision that would have allowed Medicare to reimburse doctors when they meet with patients to talk about end-of-life care.

But then Sarah Palin argued that such payments would lead to care being withheld from the elderly and disabled. Her comment ignited a firestorm among conservatives and helped fuel the opposition to the legislation. Continue reading


NYC hospitals to end filming patients without consent


Photo by Brainloc

By Annie Waldman

Bruised by criticism after a reality TV show surreptitiously recorded and aired a man’s death, New York City hospitals will no longer allow patients to be filmed without getting prior consent.

The Greater New York Hospital Association, an umbrella organization that represents all of New York City’s hospitals, has asked its member institutions to put an end to filming patients for entertainment purposes without getting their permission.

The move came in response to an issue raised by a ProPublica story published with The New York Times earlier this year.

“Our member hospitals strongly agree that patients deserve privacy in the course of receiving care and that their medical information should be kept confidential in accordance with the law,” said Kenneth E. Raske, the president of Greater New York Hospital Association, in a letter to City Council members last month. The letter was released this week.

ProPublica’s report, published in January, revealed how ABC’s reality show “NY Med” filmed the death of Mark Chanko, a patient at NewYork-Presbyterian/Weill Cornell Medical Center, without getting permission from him or his family. In July, New York City Council members demanded that city hospitals prohibit the filming of patients.

“Not everything is made for TV,” said New York councilmember Dan Garodnick in an interview. “When you go into a hospital, you deserve to know that your sensitive moments are not going to end up on primetime.”

Chanko’s family only found out about the filming after the episode featuring his death aired. The family was not even aware that camera crews had been in the emergency room during Chanko’s final moments.

[Photo by Brainloc]

Continue reading


Death with Dignity participation rises slightly in Washington


More than half of participants receiving lethal dose of medication are women

From Washington State Department of Health

It’s been six years since Washington’s Death with Dignity Act went into effect and since that time, 725 adults with a terminal illness have chosen to end their lives with a physician-prescribed lethal dose of medication.

Death with Dignity participation rose less than 2 percent in 2014.

There were 176 terminally ill patients in 2014 who received a prescription to help them end their lives. The prescriptions were written by 109 different physicians and were filled by 57 different pharmacists. Of the 176 people who received these prescriptions, 170 are known to have died.

Death with Dignity participation rose less than 2 percent in 2014 compared to the previous year, although more than half of those who died last year were women — up from 48 percent in 2013.

Screen Shot 2015-08-06 at 1.49.33 PM

Those who died after receiving the lethal medications were between the ages of 21 to 101. As in previous years, many patients choosing to receive the medication listed the loss of independence as the reason for participating.

Of the 170 participants in 2014 who died: Continue reading


Are you pregnant?


Pregnancy: A Touchy Subject In Employee Wellness Assessments

“Are you pregnant?”

PregnancyBy Julie Appleby

It’s a topic employers generally avoid, since the Pregnancy Discrimination Act of 1978 prohibited sex discrimination on the basis of pregnancy.

But women’s advocates fear these long-standing protections could be undermined by some workplace wellness programs.

That question and “How old were you when you first became pregnant?” are both included in a health risk assessment offered to some clients of Audax Health, a wellness firm.

“How old were you when you first became pregnant?”

Similar queries are posed in health risk assessments offered by other wellness programs, say consumer groups, including the National Women’s Law Center.

“These are questions they should not ask,” because of the potential for discrimination, said Emily Martin, vice president and senior counsel for the NWLC,  in a letter to the Obama administration asking for a ban on such questions in wellness programs. Continue reading


Fetal tissue attack is latest tactic in long GOP fight against Planned Parenthood


Logo_plannedparenthoodBy Julie Rovner

Republican calls to defund Planned Parenthood over its alleged handling of fetal tissue for research are louder than ever. But they are just the latest in a decades-long drive to halt federal support for the group.

This round of attacks aims squarely at the collection of fetal tissue, an issue that had been mostly settled — with broad bipartisan support —  in the early 1990s. Among those who voted to allow federal funding for fetal tissue research was now-Senate Majority Leader Mitch McConnell, R-Ky.

McConnell made no mention of his previous position when he announced that the Senate would take up a bill to cut off Planned Parenthood’s access to federal funds before leaving for its summer break. The first vote on the bill is expected as soon as Monday. Continue reading