organ transplant

The NRA versus Medical Professionals: Only One is Interested in Saving Lives

Advocating for patients is in a physician’s job description. Sometimes we forget that, and need a reminder. The National Rifle Association, a little itchy with its Twitter finger, needed a reminder.

Gun-related injuries and death are a clear public health problem, inspiring a set of guidelines by the American College of Physicians published recently in Annals of Internal Medicine.

To which @NRA had this to say: “Someone should tell self-important anti-gun doctors to stay in their lane.” Read More

Out of Touch NRA tells Front-line Healthcare Providers to “Stay In Their Lane” on Gun Control

An unnamed columnist writing for the National Rifle Association Institute for Legislative Action blog advised physicians and other healthcare providers to “stay in their lane” when it comes to advocating for gun control.

This appears to have been sparked by the position paper published in the October, 2018 Annals of Internal Medicine authored by the Health and Public Policy Committee of the American College of Physicians. The author of the blog post argues that the paper and subsequent position statement is flawed, claiming that there is “not enough evidence” to suggest that stricter gun laws would have any effect of the rates of gun violence in the United States.

The conclusion is that medical providers should keep to doing what they do best (practicing medicine) and leave the discussion of gun control to the “experts”, by which the author apparently means gun owners and the NRA.

This article would have likely been just another throw-away piece had it not caught the attention of thousands of medical providers on Twitter. Retweets carrying the hashtag #ThisIsMyLane went viral, relaying stories of gun-shot victims that physicians, nurses, EMS providers and others have had to treat. Some were accompanied by pictures of blood-stained trauma bays or operating room suites.

It seems like an odd move to criticize the very people who have to deal with the carnage of gun violence, and given the response, the NRA picked the wrong people to bully. There were more than 16,000 comments within just a few hours, mostly from healthcare providers denouncing the article and the accompanying tweet.

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image of hands texting on a smart phone

Artificial Intelligence for Suicide Prediction

Suicide is a global problem that causes 800,000 deaths per year worldwide. In the United States, suicide rates rose by 25 percent in the past two decades, and suicide now kills 45,000 Americans each year, which is more than auto accidents or homicides.

Traditional methods of predicting suicide, such as questionnaires administered by doctors, are notoriously inaccurate. Hoping to save lives by predicting suicide more accurately, hospitals, governments, and internet companies are developing artificial intelligence (AI) based prediction tools. This essay analyzes the risks these systems pose to safety, privacy, and autonomy, which have been under-explored.

Two parallel tracks of AI-based suicide prediction have emerged.

The first, which I call “medical suicide prediction,” uses AI to analyze patient records. Medical suicide prediction is not yet widely used, aside from one program at the Department of Veterans Affairs (VA). Because medical suicide prediction occurs within the healthcare context, it is subject to federal laws, such as HIPAA, which protects the privacy and security of patient information, and the Federal Common Rule, which protects human research subjects.

My focus here is on the second track of AI-based suicide prediction, which I call “social suicide prediction.” Though essentially unregulated, social suicide prediction uses behavioral data mined from consumers’ digital interactions. The companies involved, which include large internet platforms such as Facebook and Twitter, are not generally subject to HIPAA’s privacy regulations, principles of medical ethics, or rules governing research on human subjects.

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person wearing gloves holding HIV test

Southern Indiana’s HIV Outbreak: A Lesson on the Importance of Incentivizing HIV Testing

By 2015, major news outlets were reporting on what the CDC was calling “one of the worst documented outbreaks of HIV among IV users in the past two decades.” Between 2011 and 2015 over 200 people in southern Indiana’s Scott County acquired HIV. The primary source of the spread was the sharing of needles to inject opioid drugs. While the outbreak has now been contained, there linger many lessons to be learned from the tragedy that struck this small rural county in southeast Indiana.

Some of those lessons are about the havoc being wreaked on much of rural America by opioid abuse. But the lessons I’m focusing on here are the dangers of disincentivizing HIV testing, especially among high-risk populations like injection drug users. Read More

A group of college students play jenga and drink beer

The Drinking Age and Law Enforcement on College Campuses

When I was a senior in college, after having worked for the Cornell University Police Department for four years, I hosted a town hall meeting to promote and improve the Blue Light Escort Service, a service which most colleges have to give students safe, free late-night walks home by law enforcement or affiliated personnel.

One of the key takeaways of the meeting, as I knew it would be, was that many students were unsure of the relationship of the escort service to enforcement of underage drinking laws: they were scared that if they were drunk underage and called for an escort, they would get in trouble.

This post is, in a sense, about a narrow issue: the effect of the national minimum legal drinking age (MLDA) of 21 on campus law enforcement. More broadly, however, it’s about a specific and often overlooked result of a legal framework that ostensibly-but-not-really makes criminals of the hundreds of thousands of college students who live on their own and are legally considered to be adults, for behavior that virtually all other adults engage in with laws that are virtually but not entirely unenforced.

It’s kind of a weird thing, if you think about it.

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elderly person's hand clasped in young person's hands

How Would You Like to be Treated if You Had Dementia?

The New Yorker just published an article full of ethical questions about the best health care treatment for dementia patients. It should make you think about which life you would choose. Larissa MacFarquhar’s piece is titled “The Comforting Fictions of Dementia Care.” Its subtitle suggests a sad story, noting “Many facilities are using nostalgic environments as a means of soothing the misery, panic, and rage their residents experience.” The article tells numerous powerful stories of dementia patients’ good and bad experiences.

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Seeking out global patient safety research

By John Tingle

Unsafe health care is a problem of global proportions .The remedies and solutions to many patient safety problems are unlikely to be found in just one countries health care system. Health is one of the world’s great generics, it transcends countries borders, we are all dealing with the health of human beings which is the common denominator. Whilst country contexts may change the subject matter, the patient, remains constant. WHO state:

“Ensuring the safety of patients is a high visibility issue for those delivering health care – not just in any single country, but worldwide. The safety of health care is now a major global concern. Services that are unsafe and of low quality lead to diminished health outcomes and even to harm. The experience of countries that are heavily engaged in national efforts clearly demonstrates that, although health systems differ from country to country, many threats to patient safety have similar causes and often similar solutions (p.1).

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End of year report cards from NHS Resolution and the Care Quality Commission

By John Tingle

Two key NHS (National Health Service) organisations have recently produced reports. NHS Resolution has produced its annual report and accounts.The Care Quality Commission (CQC) has produced a report on the experiences of adult in -patients in NHS hospitals.These reports are excellent for real-time trend analysis and important patient safety and clinical negligence trends are identified.

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two female teenagers holding hands in Toronto

Ontario’s Sex-Ed Curriculum: A Step Back for Health and Safety

By Gali Katznelson

Come September, it seems Ontario students in grades 1-8 will follow the same sexual education curriculum that was taught in schools in 1998.tse

Days after the Progressive Conservative Party’s win in Ontario, premier Doug Ford has announced that he will scrap the province’s elementary school sex-ed curriculum and replace it with one that is twenty years old.

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Are we speaking the same language? An alphabet soup of acronyms in the opioid epidemic

By Stephen Wood

Medication Replacement Therapy (MRT), Medication Assisted Therapy (MAT). Opioid Substitution Treatment (OST). Opioid Replacement Therapy (ORT). Opioid Agonist Therapy (OAT). This confusing array of acronyms are all terms that have made their way into the dictum of patients, healthcare providers, policy leaders, politicians and journalists —and new ones pop up every day.

Buprenorphine Enabled Recovery Pathway (BERP) is one I just came up with but could just as easily make its way into the menagerie of acceptable buzzwords for using an agonist-antagonist (or other drug) for the treatment of substance use disorder.

It doesn’t stop there.

Safe Consumption Facilities (SCF), Safer Injection Facilities (SIF), another SIF in Supervised Injection Facilities, Supervised Injection Sites (SIS), Medically Supervised Injection Sites (MSIS), and Drug Consumption Sites (DCS) only begin to round out the list of areas that people who use intravenous drugs can go to use in a safe, clean and supported environment.

We see these terms bantered about in the media, among healthcare providers, legislators and policy makers. We hear them from patients with SUD, their families as well as advocate organizations. These terms are in published research reports and clinical studies. To even the savviest person though, it is a confusing alphabet soup of acronyms that are all trying to describe an array of programs, possibly something similar or maybe even the same.

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