Category: Medical Quality

Doctor working with modern computer interface.

Harms and Biases Associated with the Social Determinants of Health Technology Movement

The Petrie-Flom Center Staff Leave a comment

By Artair Rogers

Many health systems have begun using new screening technologies to ask patients questions about the factors outside of the clinic and hospital that contribute to an individual or family’s health status, also known as the social determinants of health (SDOH). These technologies are framed as a tool to connect patients to needed community resources. However, they also have the potential to harm patients, depending on how patient data is used. This article addresses key harms and biases associated with the SDOH technology movement, and provides suggestions to address these issues going forward.

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WASHINGTON, DC - OCT. 2, 2021: Women's March in Washington demanding continued access to abortion after the ban on most abortions in Texas, and looming threat to Roe v Wade in upcoming Supreme Court.

How the Dobbs Ruling Will Affect People with Substance Use Disorder

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By Hayfa Ayoubi and Karishma Trivedi

At the young age of 21, Regina McKnight unexpectedly suffered a stillbirth due to umbilical inflammation. She was a grieving mother, but to the state of South Carolina, she was a killer. In 2001, prosecutors charged McKnight with homicide allegedly caused by her use of cocaine while pregnant. The jury in the case returned a guilty verdict after deliberating for thirty minutes. It was not until years later in 2008 that her wrongful conviction was overturned by the state’s Supreme Court. 

Unfortunately, McKnight is one of many marginalized women of color who make up the majority of individuals criminally prosecuted for substance use during pregnancy. Now that the constitutional protection for abortion under Roe v. Wade has been overturned, more women like McKnight will have the full power of the state brought to bear on them through forced procedures, surveillance, and jail sentences solely because they happened to get pregnant. 

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Washington, DC USA May 3 2022: Protesters gather at the US Supreme Court after a report that the count will overturn Roe vs Wade, ending the constitutional right to abortion.

An Ob/Gyn Reflects on Dobbs: ‘The Time Has Passed for Neutrality’

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By Samantha DeAndrade

Last week, in response to a petition written by myself and colleagues, the American Board of Obstetricians and Gynecologists (ABOG), which is headquartered in Texas, reversed its decision to pursue in-person board certification exams.

In light of the Supreme Court’s ruling in Dobbs vs. Jackson Women’s Health, my colleagues and I held grave concerns about traveling to Dallas, Texas for this credentialing exam. We worried for our patients, our colleagues, and — though hard to admit it — ourselves.

In our petition, we cited concerns about the well-being of our pregnant colleagues who might encounter a pregnancy complication while in Texas and not have the full range of life-saving, evidence-based options available. We also expressed fear for our personal safety as abortion providers in a state where anti-abortion vigilantes are allowed to sue anyone who performs or assists in a pregnancy termination. It also felt wrong to contribute to the economy of a state that has passed the most restrictive abortion laws in recent history; a decision we know is about power and politics, not patient safety.

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Asbury Park, NJ - January 21, 2017: "My Body My Choice" sign at Women's March and worldwide protest.

The Only Moral Abortion is…

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By Carmel Shachar

Since June 24, 2022, I have spent a lot of time thinking through the post-Roe legal and ethical landscape, both publicly and privately. Very often, the discussion is centered about the impact that Dobbs v. Jackson Women’s Health Organization will have on patients whose health or lives are threatened by their pregnancies — such as people with ectopic pregnancies, missed miscarriages with a high risk of sepsis, and preeclampsia — and the physicians who care for them.

These cases are, no doubt, important. But I am writing this piece to provide a counterpoint to this public discussion: abortion should be safe, legal, and accessible not only when the patient’s life or health is in danger. When we focus on the “blameless” abortions, such as the underage victims of incest, or the woman who wanted to be a mother but found out she has cancer that needs to be treated, we cede ground on this issue, by playing into the notion (whether knowingly or not) that some abortions are more justified or acceptable than others.

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Gavel and stethoscope.

How to Assess the Impact of Medical Ethics Education

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By Leah Pierson

There has been too little evaluation of ethics courses in medical education in part because there is not consensus on what these courses should be trying to achieve. Recently, I argued that medical school ethics courses should help trainees to make more ethical decisions. I also reviewed evidence suggesting that we do not know whether these courses improve decision making in clinical practice. Here, I consider ways to assess the impact of ethics education on real-world decision making and the implications these assessments might have for ethics education.

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Washington, DC, USA, May 5, 2022: people protest the leaked draft Supreme Court opinion overturning Roe v. Wade and the right to abortion

The Leaked Dobbs Opinion, Explained

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By Chloe Reichel

On May 2, 2022, Politico published a leaked draft of the majority opinion in Dobbs v. Jackson Women’s Health Organization, which showed the Supreme Court’s intent to overturn the right to abortion as decided in Roe v. Wade.

In response to the leak, the Petrie-Flom Center hosted a discussion with legal historian and Daniel P.S. Paul Visiting Professor of Constitutional Law Mary Ziegler and Petrie-Flom Center Faculty Director, James A. Attwood and Leslie Williams Professor of Law, and Deputy Dean I. Glenn Cohen.

Together, Cohen and Ziegler explained the background of the case, the contents of the draft opinion, and its potential implications not just for abortion access, but also for other constitutionally-protected rights, and for access to reproductive technologies, such as in-vitro fertilization.

The highlights of the conversation have been edited and condensed below.

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London, England, UK, January 22nd 2022, Long covid symptoms sign on pharmacy shop window UK.

Mobilizing Long COVID Awareness to Better Support People with Acquired Disabilities

The Petrie-Flom Center Staff Leave a comment

By Marissa Wagner Mery

Long COVID exposes an often-unacknowledged facet of disability: that one is far more likely to develop a disability than be born with one.

Estimates suggest that, at present, approximately 10 – 20 million Americans are now afflicted with the array of debilitating symptoms we now call Long COVID, which include fatigue, shortness of breath, and cognitive dysfunction or “brain fog.”

The upswell of advocacy and awareness around Long COVID should be mobilized to call attention to and address the challenges faced by newly-disabled adults, particularly with respect to employment.

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Doctors performing surgery.

The Need to Go Back to Basics in Patient Safety

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By John Tingle and Amanda Cattini

In the hustle and bustle of our daily professional lives, it is sometimes all too easy to forget about the basics. In terms of health care practice and patient safety, these underpinning basic, foundational concepts include the need for proper patient communication strategies.

The consequences of failures in patient communication can be devastating. There is a need to go back to this basic issue at regular intervals.

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