Bioethics @ TIU

Racial inequalities in cancer survival

Posted December 9th, 2017 by Joe Gibes

Three studies published in a supplemental issue of the journal Cancer this month come to disturbing conclusions: in the United States, the survival rates for colon, breast, and ovarian cancer are lower for black people than for white people. The news isn’t all bad: overall cancer survival rates are going up. The three studies mentioned here draw from two larger studies of worldwide cancer survival, the CONCORD… // Read More »

The unbefriended and their doctors

Posted September 16th, 2017 by Joe Gibes

There is a rapidly growing class of uniquely vulnerable patients showing up on our hospital doorsteps. Referred to as the unbefriended, or more prosaically as the unrepresented, these are patients who have no capacity to make medical decisions themselves, have no advance directives, and have no family or friends or anybody else on the face of the earth to speak for them. It is as… // Read More »

Undermining the USPSTF: The most important stakeholders are the patients

Posted May 12th, 2017 by Joe Gibes

A strange “health care” drama plays out daily in our clinics and hospitals. A healthy person has a medical test done (even though he or she is healthy): a blood test, a chest x-ray or mammogram, maybe an ultrasound of some body part. The test comes back abnormal. The patient (for she has now gone from being a healthy person to being a patient) is… // Read More »

All We Need is (Unconditional) Love

Posted April 26th, 2017 by Chris Ralston

On March 24, 2017, Joe Gibes posted an entry on this blog, entitled “A ‘disabled’ person speaks out against a particular form of discrimination.”[1] That post featured links to several stories about Kathleen Humberstone, a young woman with Down Syndrome who spoke at a recent UN event commemorating World Down Syndrome Day, which was observed on March 21. After reading through Joe’s post and the… // Read More »

How to make Nazi doctors

Posted April 21st, 2017 by Joe Gibes

Most people who go into medicine have as at least part of their motivation the desire to help other people. I’m sure this was as true in 1930’s Germany as anywhere else. So how did a cadre of Nazi doctors come not only to commit crimes against humanity, but also to defend the moral correctness of their conduct when placed on trial for those crimes?… // Read More »

But at least we don’t have socialized medicine

Posted March 11th, 2017 by Joe Gibes

I just read T. R. Teid’s 2009 book The Healing of America. It’s a timely read in light of the bar brawl over health care that’s brewing in the U.S. legislature this week. Of particular interest are his snapshots of the health care systems of the UK, France, Germany, Japan, Taiwan, Canada, and Switzerland, systems about which I held many cherished misconceptions. All of these countries… // Read More »

A Conflict of Interest is NOT an Ambiguity

Posted February 19th, 2017 by D. Joy Riley

Oregon Senate Bill 494 has been described as a “euthanasia bill” that is “intentionally ambiguous,” and as a piece of legislation that would “allow the starving and dehydrating of patients who suffer from dementia or mental illness.” What has received less press is the composition of the 13-member committee who would be perpetually in charge of advance directive forms in the state, with no oversight by… // Read More »

Advance Care Planning and its Detractors

Posted February 18th, 2017 by Joe Gibes

The default mode of our technologically advanced medicine is to use our technology. Nowhere is this more true than close to the end of life. And our technology is really impressive; with it, we can keep chests going up and down and hearts beating for a long, long time. The troubling thing is that there are many people who would rather not have lots of… // Read More »

Apologies and Outcomes

Posted February 10th, 2017 by Joe Gibes

What if a study shows that the course of action we know to be right doesn’t “work”? Or that it may even place us at a disadvantage? When bad things happen to patients in the course of medical treatment, doctors traditionally have avoided apologizing or even expressing sympathy to patients, for fear that such expressions would be used against them in malpractice court as an… // Read More »

Excuse Me, Doctor, What Exactly Do You Profess?

Posted February 5th, 2017 by D. Joy Riley

The late Edmund Pellegrino, M.D., revered medical educator, ethicist, and physician, often made the point that a professional professes something. Merriam-Webster  confirms that the etymology of the word, profession, includes the Latin for “public declaration.” The Hippocratic Oath, probably penned by members of the Pythagorean sect, according to Ludwig Edelstein (see Ancient Medicine: Selected Papers of Ludwig Edelstein. Baltimore: Johns Hopkins University Press, 1987), has for… // Read More »