Security and Health: Police as Key Players in Public Health

For more than a decade, a variety of scholars and practitioners in public health, policing and the broader domain of security have been stoking a conversation about the links between their disciplines and the need to do a better job integrating the disciplines and practices.

This week, The Lancet published a special series on Security and Health. A global set of authors, myself included, make the case that military and police forces should be recognized as key players, rather than intruders, in public health, and therefore we need these relationships to be backed by investment in partnerships and reform. Take a look. You may even be inspired to put the next global Law Enforcement and Public Health Conference on your agenda, set for Edinburgh in October.

 

Telemedicine. Image of a patient speaking to a doctor on a mobile phone.

Telemedicine Adds a Wrinkle to Latest New Mexico Legislative Debate on Aid in Dying

Then-Senate Majority Leader Bill Frist was roundly criticized in 2005 for declaring that Terri Schiavo, a Florida woman who had gone into cardiac arrest at age 26, was “not somebody in persistent vegetative state” after viewing videotapes of her condition. The tragic situation is mostly remembered as a low point for federalism and end of life policy.

But there is another issue stemming from the debate that ought to be considered. Although Frist backed away from calling his review of videos an actual diagnosis, it is interesting to think how the use of technology to make a remote determination of a patient’s condition has changed since Frist made his assessment.

Indeed, over a decade later, a New Mexico bill is proposing the opposite: allowing individuals with a terminal illness to utilize telemedicine consultations to seek aid to end their lives. It is not surprising that New Mexico lawmakers would consider telemedicine as part of their proposal. Given its geography, the state has embraced telemedicine as a means of expanding access, and innovative workforce initiatives such as Project ECHO were birthed there.

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A protester holds a sign with a quote that reads: "Pf all the forms of inequality injustice in health care is the most shocking and inhumane."

We Shouldn’t Be Focusing on Whether Healthcare Is a Right

The call for “Medicare for All” has grown louder and its cadence more frequent. Even President Obama has expressed support for it. Increasingly, as policymakers and stakeholders debate the path forward for healthcare in the U.S., a familiar invocation of human rights language can be heard.

The sentiment that “healthcare is a right” — rather, that it should be a right — has many layers. Its complexity is more accurately captured as “health(care) is a (human) right”. These parens make my head spin, too. They also suggest that Medicare for All is at best a piecemeal solution to the causes of poor health in the U.S. Read More

Reality star Kim Kardashian at the CFDA Awards at the Brooklyn Museum on June 4, 2018.

Can Kim Kardashian Help Bioethics? Celebrity Data Breaches and Software for Moral Reflection

In 2013, Kim Kardashian entered Cedars-Sinai Medical Center in Los Angeles.

During her hospitalization, unauthorized hospital personnel accessed Kardashian’s medical record more than fourteen times. Secret “leaks” of celebrities’ medical information had, unfortunately, become de rigueur. Similar problems befell Prince, Farah Fawcett, and perhaps most notably, Michael Jackson, whose death stoked a swelling media frenzy around his health. While these breaches may seem minor, patient privacy is ethically important, even for the likes of the Kardashians.

Since 2013, however, a strange thing has happened.

Across hospitals both in the U.S. and beyond, snooping staff now encounter something curious. Through software, staff must now “Break the Glass” (BTG) to access the records of patients that are outside their circle of care, and so physicians unassociated with Kim Kardashian’s care of must BTG to access her files.

As part of the BTG process, users are prompted to provide a reason why they want to access a file. Read More

HIPAA is the Tip of the Iceberg When it Comes to Privacy and Your Medical Data

Big data continues to reshape health. For patient privacy, however, the exponential increase in the amount of data related to patient health raises major ethical and legal challenges.

In a new paper in Nature Medicine, “Privacy in the age of medical big data,” legal and bioethical experts W. Nicholson Price and I. Glenn Cohen examine the ways in which big data challenges the protection (and the way we conceive) of health care privacy. Read More

3 Things You Should Know About the Petrie-Flom Center’s 2019 Annual Conference

Breakthroughs in genetics have often raised complex ethical and legal questions, which loom ever larger as genetic testing is becoming more commonplace, affordable, and comprehensive, and genetic editing becomes poised to be a consumer technology. As genetic technologies become more accessible to individuals, the ethical and legal questions around the consumer use of these technologies become more pressing.

We are excited, therefore, to have many major thought leaders in this space discuss these issues at the Petrie-Flom Annual Conference, “Consuming Genetics: Ethical and Legal Considerations of New Technologies,” which will take place at Harvard Law School in May. Read More

The Emergency Department is The “New” Frontier of Public Health

I had always considered my field of expertise to be emergency medicine. I worked through the ranks as an emergency medical technician, then onward as a paramedic, which included a nine-year stint on a busy medical helicopter. I worked in disaster medicine, and was the associate director of a Harvard-affiliated disaster medicine fellowship in Boston. My current practice is as a nurse practitioner in a busy suburban emergency department (ED) and I am still active in emergency medical services as a SWAT medic and as an educator.

The emergency part of what I do is the exciting part —the part that stimulates the excitatory neurotransmitters that flood the brain, preparing it to act quickly and concisely.

We are selling ourselves short, however, when we label this role as “emergency” providers. Instead, “public health provider” is a much more appropriate term to use, because emergency departments and those who provide care there are really public health workers.

All of us who practice in emergency medicine know that real emergencies are few and far between. Our day-to-day is much more mundane. We deal with many urgent issues as well as some less urgent, primary care problems. We may even spend time filling printer paper or bringing a patient their lunch. We may help to find someone a homeless shelter, send a family home with warm coats for the kids, or pack up a bag with food and toiletries for a young girl we feel is being trafficked.

In light of all this, the purpose and the policies of the emergency department need to be redefined. Read More

Call for Proposals: ASLME Health Law Professors Conference

Loyola University Chicago School of Law and the American Society of Law, Medicine & Ethics look forward to hosting the 42nd Annual Health Law Professors Conference on June 5-7, 2019 in Chicago.

We welcome your proposals for the conference program, which should be submitted via this form by January 15, 2019.

We are also pleased to introduce a new opportunity to publish your work in a special post-conference issue of the Journal of Law, Medicine & Ethics. Further details are provided below the fold.

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