Bioethics @ TIU

From Coercion to Christmas

Posted December 23rd, 2017 by Joe Gibes

The recent wave of stories of sexual abuse and harassment led my residents (I teach family medicine residents) and me to a discussion of sexual ethical violations in medicine. The annals of disciplinary actions by state medical boards are filled with penalties inflicted upon physicians who have entered into sexual relationships with patients. Why is it that in the patient-physician relationship, sexual intimacy between two… // Read More »

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 »

Ethical Health Care Reform

Posted July 21st, 2017 by Joe Gibes

Recently I heard a Christian TV personality refer to Obamacare as “iniquitous.” This started me thinking, What would make a health care funding reform scheme “iniquitous”? Or, although the words aren’t synonymous, what would make such a scheme unethical? What should go into ethical health care reform? The answers to these questions are legion and conflicting. There are some who see government intervention as inherently… // Read More »

Health care disparities: a pro-life issue

Posted June 9th, 2017 by Joe Gibes

This month’s Health Affairs carries an article examining the correlation between one’s income and one’s perceptions about one’s own health and health care. Worldwide, those with the lowest incomes feel that their health is worse than those with the highest incomes do. They also are more likely than those with higher incomes to skip necessary treatment because they can’t afford it, and are more concerned that if… // 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 »

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 »