December 2009
Nurses, Doctors Rank Among The Most Trusted Professionals in Society. Who's At The Bottom? You Guessed It. Joseph Lieberman and the Gang.
You might be surprised to learn that nurses (and healthcare professionals generally) are among the most trusted members of society, according to the annual Gallup "Honesty and Ethics of Professions" poll. Evidently, Americans believe that health professionals don't lie (except when they think it's good for you, if you read the most recent AJOB, or if you are Dr. House).
On the other end of the spectrum are politicians, the pond scum of the honest and ethics poll. They rank alongside, according to The Hill Blog Briefing Room, such lowlifes as the proverbial car salesmen, evil HMO managers, and Wall Street stockbrokers!
Where has our trust in American government gone? It appears to have gone right down the toilet with the public option, Medicare starting at age 55, and a whole string of political compromises and proposals that might have made health reform possible.
In order for trust to be restored, politicians will have to start making good on their promises and start delivering results to the American people. Perhaps they will start by figuring out a way to provide health care for all Americans.
Summer Johnson, PhD
Summer Johnson Talks about AJOB's December Issue
On the Center for Practical Bioethics' blog, you can hear me talk about the ethical questions raised by the use of placebos in clinical practice and the other topics addressed by the Target Articles in the December issue of AJOB, including life extension and the moral responsibilities of journal editors to have a policy for publishing animal studies.
In addition, I discuss what lies ahead for AJOB in 2010. In particular, we discuss the upcoming January issue for AJOB and AJOB's newest additions---AJOB Neuroscience and AJOB Primary Research.
To learn more, click on the link above. To hear more of the Center for Practical Bioethics' podcasts, click here.
Summer Johnson, PhD
Come One, Come All--To Neuroscience Boot Camp!
Our colleagues at the University of Pennsylvania are having another "Neuroscience Boot Camp". To learn more, read below or click the link above.
Summer Johnson, PhD
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Calling all bioethicists who'd like to know more neuroscience!
Penn is once again offering Neuroscience Boot Camp, a ten-day intensive program for academics and professionals in bioethics, law and other fields who want to be able to work knowledgeably with neuroscience. Last summer's Boot Camp was a great success, with lectures, panel discussions, lab visits and breakout groups, and we are planning to make this one even better!
Here is what some of last year's campers had to say:
"Neuroscience boot camp was fabulous. I got a basic overview of the field from first-rate researchers who also happen to be superb teachers. They were as open to answering basic questions about the science as they were eager to engage the larger philosophical and legal questions that brought many of us to camp. Truth be told, it wasnt just edifying. Spending time with a bunch of curious professionals who wanted to learn some basics about a field other than their own was just really, really fun." -- Erik Parens, Ph.D., Senior Research Scholar, The Hastings Center
"Martha's leadership and lectures have been absolutely fantastic, and
the other lectures, field trips, and lab demonstrations have been
equally wonderful. I cannot imagine a better way to improve my
understanding of neuroscience and am eager to bring my new knowledge to
bear on my scholarship in law and the medical humanities." -- Stacey Tovino, JD, Ph, Director, Health Law and Policy Center, Drake University Law School
Apples, Oranges, and Comas by Art Caplan
Wesley Smith has a new column out,
in which he inappropriately uses the case in Belgium of Rom Houben to argue that somehow Terri Schiavo should not have
been permitted to have her feeding tube removed.
Smith argues that a case of locked-in syndrome is somehow analogous to the chance of recovery for someone in a PVS state post anoxia. I would like to have him find three neurologists who agree with that claim.
Terri Schiavo suffered anoxia to her brain--twice! her brain damage was confirmed while she was alive by CAT scan and then at autopsy. She was BLIND despite the alleged tapes that were made showing her tracking objects. Her cortex had shriveled to to half its normal mass.
To equate the discovery of Houben's locked in state with the idea that this provides any reason to challenge Terri Schiavo's diagnosis and prognosis is not
consistent with the facts and does a disservice to those who grapple with the treatment of loved ones who are in PVS states due to anoxia.
The argument about Houben, or at least my argument, is not that he might be conscious and his locked-in state misdiagnosed for many years but rather with the technique of faciliated communication that is being used as the way to 'communicate' with him. FC has been found to be unreliable by many medical and scientific groups. Worse it has a history of being misused in legal cases involving allegations of child abuse that have led U.S. courts to reject it out of hand. Time and again the therapist has been shown to be the source of messages when FC is used. Does Smith credit this technique?
The Houben--Schiavo analogy is completely bogus--they are apples and oranges. It is time for more experts in neurology and the brain sciences
to speak up about the way
in which the Houben case is being misused by those who are still trying to vindicate their erroneous views on the Schiavo case.
As a final point, it is important to point out that not only was Terri Schiavo in a PVS state with 100% certainty, but her husband could have directed her care to be stopped in the State of Florida even if she had been in a minimally conscious state or, for that matter, a 23 year locked-in state. No one is bound to accept medical care if it violates their religious or personal views about what they want from medical interventions. The fact that Wesley is arguing that Houben proves there was hope for Terri Schiavo neglects the core issue of the case--can a spouse direct care be stopped on the grounds that it's provision violates the wishes and values of the patient.
Michael Schiavo insisted his wife would not want to be kept alive in a PVS state. Schiavo's parents and siblings disagreed. But ultimately in Florida the view of the spouse trumps that of the parents/siblings.
With the fifth anniversary of Schiavo's death approaching it is important to get the facts straight and not let ideology drive the ethical assessment of the propriety of
family and patient decisions about what they wish in terms of medical care whether at the end of life or at any other point in their lives.
Arthur Caplan, PhD
