Tag Archives: ethics

Voice-recognition to automate doctors’ data entry

Voice-recognition system aims to automate data entry by doctors – STATBy Casey Ross @caseymrossMarch 4, 2019

I think artificial intelligence (AI) in healthcare simply must happen with so many people’s care sprawling over so many healthcare services (and billing companies). Using AI learning systems in healthcare makes a mockery of any kind of patient or doctor privacy. Even worse, they are dangerously prone to undetectable errors (people have died).

Still, we need these systems to cope with the ever-increasing amounts of data and knowledge, but we need them to serve humans, not to replace them.

Hands down, the one task doctors complain about most is filling out the electronic health record during and after patient visits. It is disruptive and time-consuming, and patients don’t like being talked to over the doctor’s shoulder.    Continue reading

Ethics of Using Facial Recognition Tech in Healthcare

What Are Important Ethical Implications of Using Facial Recognition Technology in Health Care?AMA Journal of Ethics – Nicole Martinez-Martin, JD, PhD

Abstract:

Applications of facial recognition technology (FRT) in health care settings have been developed to identify and monitor patients as well as to diagnose genetic, medical, and behavioral conditions.

The use of FRT in health care suggests the importance of informed consent, data input and analysis quality, effective communication about incidental findings, and potential influence on patient-clinician relationships.

Privacy and data protection are thought to present challenges for the use of FRT for health applications.  Continue reading

Ethical Issues in Population Health Programs

Ethical Issues in the Design and Implementation of Population Health Programs – free full-text /PMC5834965/ – J Gen Intern Med. – 2018 Mar

When a single doctor is supposed to work both for a “population” and an “individual”, ethical problems are inevitable. I doubt any patient wants to be treated as just a standard member of a “population”.

This is the current problem that pain patients are having: because we need a drug that is also used illicitly (by others), we are treated as though we were members of the “population” of “illicit drug users”.

Instead of receiving treatments that are effective for our pain and tailored to our individual needs, we are literally treated like “people with addiction” instead of “people with pain”.

specific population health activities may not be in every patient’s best interest in every circumstance, which can create ethical tensions for individual physicians and other health care professionals.   
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Patient Care and Population Health

Patient Care and Population Health: Goals, Roles and Costs –  free full-text /PMC4207028/ – Aug 2014

We should welcome efforts that encourage clinicians to avoid tests and treatments that do not improve health and thereby waste valuable resources

But we should critically evaluate proposals that assign clinicians the direct double responsibility of

  1. meeting the medical needs of patients while
  2. simultaneously meeting the economic needs of populations.

Why should we be sceptical? For two reasons.    Continue reading

Industry-Funded Studies and the Skewing of America

I stumbled across this interesting publication that’s dedicated to reporting on the “cheating” that goes on as our country moves to privatize more and more services

Tarbell uncovers how powerful people and companies use their influence to shape a system that works for them, not you. We highlight solutions to pressing problems.

This puts our lives in the hands of corporations whose “moral imperative” is to make money for their shareholders, while all other goals and concerns (like patient outcomes) exist only in service of this “prime directive”.  Continue reading

60 Minutes Fails to Represent Pain Patient Perspective

60 Minutes Fails to Represent Pain Patient Perspective By Laura Mills, Kate M. Nicholson, and Lindsay Baran – Mar 2019

CBS heaved out another stigmatizing and inaccurate media “story” (didn’t qualify to be called a “report”) about opioids and those who must take them. Here is the response, which points out the “pain” side of opioids (instead of just the “addiction” side).

In a Feb. 24 segment, CBS’s 60 Minutes accused the Food and Drug Administration (FDA) of igniting the overdose epidemic in the United States with its “illegal approval of opioids for the treatment of chronic pain.”

While the program highlighted the adverse consequences of misleading pharmaceutical marketing and lax government oversight, this segment failed to consider the perspective of patients who legitimately use opioids for pain, stigmatized them as drug-seekers, and propagated misconceptions about the overdose crisis, such as the idea that opioid treatment for chronic pain is indisputably illegitimate and is driving overdose deaths in the US.   Continue reading

Anger is Destructive when Expressed on Social Media

Below is a Twitter stream regarding the expression of anger and its consequences. Two of our best advocates are warning that “letting it all hang out” on social media may be counter productive.

Kate Nicholson – @speakingabtpain – Mar 2019

More people in #pain who are being tapered down or off of medication are reaching out & speaking of suicide.

I am sympathetic to the difficulty of losing access to pain medicine, but I am not a mental health professional. Some helpful thoughts from @StefanKertesz follow:   Continue reading

What We Can and Cannot Control

Genes, Environment, and Luck: What We Can and Cannot Control – Quillettewritten by Michael Shermer – Jan 2019

I’m posting this article because it applies to chronic pain, which usually starts with an unlucky event, like injuries from a car accident, or from our genes, like sickle-cell disease or EDS, or develops as a natural consequence of living life, like chronic back pain from hard physical labor.

The deeper I looked into the matter of how lives turn out, in fact, the more I realized how much is out of our control.

Let’s begin with a question: Why do some people succeed in life while others fail?

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Opioid Crisis: No Easy Fix to Social and Economic Causes

Opioid Crisis: No Easy Fix to Its Social and Economic Determinants – Feb 2018

The accepted wisdom about the US overdose crisis singles out prescribing as the causative vector.

I don’t see how this wrong idea can be called “accepted wisdom” when it is much more akin to “accepted nonsense” and “urban legend”.

Although drug supply is a key factor, we posit that the crisis is fundamentally fueled by economic and social upheaval, its etiology closely linked to the role of opioids as a refuge from physical and psychological trauma, concentrated disadvantage, isolation, and hopelessness.   Continue reading

Structural Iatrogenesis leading to “Opioid Misuse”

Structural Iatrogenesis — A 43-Year-Old Man with “Opioid Misuse” – Scott Stonington, M.D., Ph.D., and Diana Coffa, M.D. – February 21, 2019

Here’s a quick summary of a terrifying story:

“When he gets tangled in new restrictive policies on opioid prescribing, a factory worker with severe rheumatoid arthritis, whose pain must be managed for him to perform his job, ends up buying oxycodone from a friend.”

(I’ve quoted almost all the text of this case study because the NEJM is now behind a paywall with only 3 free articles a month, suddenly restricting our access to what our doctors are reading and upon which they base our treatments – just another screw being tightened on patients.) Continue reading