HealthLawProf Blog

Editor: Katharine Van Tassel
Akron Univ. School of Law

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Friday, December 19, 2008

Takings and Public Health

Marcia Coyle writing at Law.com reports on takings and public health - a potential expense that most have not considered when thinking about public health measures.  She writes,

Eggs2_2 Behold the table egg. A popular staple of breakfast and baking, eggs are at the center of a major and lengthy property rights battle in a federal appellate court that could affect all types of federal regulation on behalf of public health and safety.

The U.S. Court of Appeals for the Federal Circuit, an important forum for Fifth Amendment "takings" litigation between the federal government and business and private parties, recently heard the government's appeal of a lower court ruling that the government must pay nearly $9 million for a "takings" in connection with its effort to stop the spread of salmonella outbreaks almost two decades ago. Rose Acre Farms v. U.S., No. 2007-5169.

The takings decision by the U.S. Court of Federal Claims "raises a disturbing possibility" that government officials, when considering how best to protect public health and safety, will have to take into account a possible takings claim every time they regulate to take unsafe products off the market, said Elizabeth Wydra, chief counsel to the Constitutional Accountability Center, which filed an amicus brief in the Federal Circuit on behalf of eight consumer, public health, safety and science organizations.

"There could arguably be an extrapolation from this case that anytime government regulates to respond to a national disaster or terrorist attack that causes loss to businesses, that could be a takings that taxpayers would have to pay for," she said, adding, "We are very interested in making sure public health and safety gets predominate weight in balancing business interests and protecting the public." . . . .

At the end of the Federal Circuit argument in the case, Chief Judge Paul Michel, a member of the three-judge panel, said, "This is a very interesting and very troublesome case. Guidance from above has not always been crystal clear in the Fifth Amendment takings area, as lawyers have observed before me." . . . .


 

December 19, 2008 | Permalink | Comments (0) | TrackBack (0)

The Brain and Crime and Punishment

The National Law Journal reports on new studies that allegedly demonstrate how individuals sitting on juries make decisions about criminal culpability.  The story states,

Brain_witelson Researchers from Vanderbilt University used magnetic resonance imaging (MRI) machines to chart brain activity as subjects were asked to determine issues of guilt, innocence and punishment in a range of circumstances. It was the first time researchers have actually watched the brain at work as people made legal decisions, said Owen Jones, a professor of law and biology at Vanderbilt and one of the study's authors. The study is released in this month's issue of the journal, Neuron.

The research showed that different parts of the brain were triggered when subjects were asked to determine guilt or innocence, as opposed to when they were asked to determine a level of punishment. The analytical part of the brain — called the dorsolateral prefrontal cortex — was active when subjects were asked to decide whether or not people deserved to be punished. But the part of the brain that is responsible for emotions was triggered when people were asked to decide the level of punishment deserved in the scenarios.

"One of the major findings is that the decision to punish versus how much to punish may be determined by different brain functions," said René Marois, a neuroscientist at Vanderbilt who worked with Jones on the study. Marois cautioned that the research doesn't necessarily mean that emotions drive decisions on punishment, but they do "raise the possibility that emotional responses to criminal acts may represent a gauge for assessing deserved punishment.". . .

Owens said that this research alone isn't going to transform the justice system as we know it, but it has highlighted areas where further study is needed to help identify what role emotions play in decisions on crime and punishment.  Although monitoring brain activity on an MRI machine can tell researchers which areas of the brain are responding, it won't provide a deeper understanding of why people make certain punishment decisions, he said.

December 19, 2008 | Permalink | Comments (0) | TrackBack (0)

Thursday, December 18, 2008

Conscience Rule Regulations

The Washington Post's Rob Stein examines the Bush Administration's new conscience rule regulations.  He writes,

The Bush administration yesterday granted sweeping new protections to health workers who refuse to provide care that violates their personal beliefs, setting off an intense battle over opponents' plans to try to repeal the measure.

Critics began consulting with the incoming Obama administration on strategies to reverse the regulation as quickly as possible while supporters started mobilizing to fight such efforts.

The far-reaching regulation cuts off federal funding for any state or local government, hospital, health plan, clinic or other entity that does not accommodate doctors, nurses, pharmacists and other employees who refuse to participate in care they find ethically, morally or religiously objectionable. It was sought by conservative groups, abortion opponents and others to safeguard workers from being fired, disciplined or penalized in other ways.

But women's health advocates, family planning proponents, abortion rights activists and some members of Congress condemned the regulation, saying it will be a major obstacle to providing many health services, including abortion, family planning, infertility treatment, and end-of-life care, as well as possibly a wide range of scientific research.

The 127-page rule, which was issued just in time to take effect in the 30 days before the change in administrations, is the latest that the administration is implementing before President Bush's term ends.

The "right of conscience" rule could become one of the first contentious tests for the Obama administration, which could seek to reverse the rule either by initiating a lengthy new rulemaking process or by supporting legislation already pending in Congress.

President-elect Barack Obama's transition team did not specifically address the rule yesterday, but spokesman Nick Shapiro issued a statement that said Obama "will review all eleventh-hour regulations and will address them once he is president." Obama criticized the regulation when it was proposed last summer. . . .

December 18, 2008 | Permalink | Comments (0) | TrackBack (0)

Conscience Rule Regulations

The Washington Monthly discusses and critiques the new conscience rule regulations that will go into effect next month.  Hilzoy reports,

The rule (pdf) covers not just employees who refuse to perform a medical procedure they find objectionable, but to those who refuse to refer people to others who do provide such services. It would, for instance, protect people who not only refuse to perform abortions themselves, but who refuse to tell their patients who else might provide one, where to get the morning-after pill, etc. (See p. 106.) And as the Post notes, it would prevent organizations whose mission is to provide a small set of services from "discriminating against" people who refuse to perform those very services. (E.g., Planned Parenthood can not "discriminate against" people who object to providing contraception, even though providing contraception is 38% of their services delivered.) . . . .

Seriously: I am all for employers trying to accommodate their employees' religious convictions, when they can do so without compromising (in the case of medical employers) either the care they provide or the interests of their patients. Thus, if one of thirty Ob/Gyns in a large hospital believed that it would be wrong for her to perform abortions, I think it would be great for that hospital to arrange for other doctors to perform any abortions that were required, while asking her to take up the slack in some other way.

But the qualification "when they can do so without compromising either the care they provide or the interests of their patients" is crucial. And there are very clear limits to this, limits that this rule does not respect. My imaginary Christian Scientist doctor was meant to point that out. But the idea that it should be illegal for Planned Parenthood clinics to take someone's willingness to offer contraceptive services into account in hiring decisions is almost as absurd as saying that they should not be able to take into account that person's being a Christian Scientist.

Moreover, being unwilling to refer patients to (for example) providers of abortion or contraception always compromises the interests of patients. Doctors are supposed to explain patients' alternatives to them, and to provide the relevant referrals. They are not supposed to mention only that subset of those alternatives that they approve of on non-medical grounds -- grounds their patient might or might not agree with. The decision whether or not to have an abortion, to go on the pill, etc., is the patient's, not the doctor's. Keeping patients in the dark about those alternatives, or refusing to tell them how to obtain them, is paternalistic, and it's wrong. If a doctor doesn't want to provide such referrals, she should have gone into ophthalmology.

It's an odious rule. Luckily, as Steve noted yesterday, it probably won't last very long.

More critique can be found here.


 

December 18, 2008 | Permalink | Comments (0) | TrackBack (0)

Arthur Caplan on Fresh Air

Earlier this week on Fresh Air, Professor Arthur Caplan, director of the Center for Bioethics at the University of Pennsylvania, discussed a variety of health issues that President-elect Barack Obama may face during his administration.  He also examined some of the ethical issues surrounding the face transplant that recently occurred at the Cleveland Clinic.  It is an interesting and informative listen.

December 18, 2008 | Permalink | Comments (0) | TrackBack (0)

Wednesday, December 17, 2008

Face Transplant

The New York Times reports on the face transplant that took place this week at the Cleveland Clinic.  It is truly an amazing story raising lots of complicated ethical issues.   

Only the forehead, upper eyelids, lower lip, lower teeth and jaw are hers.  The rest of her face comes from a cadaver.  In a 23-hour operation, transplant surgeons have given nearly an entire new face to a woman with facial damage so severe that she could not eat on her own or breathe without a hole in her windpipe, doctors at the Cleveland Clinic said here on Wednesday.

The highly experimental procedure, performed within the last two weeks, was the world’s fourth partial face transplant, the country’s first, and the most extensive and complicated such operation to date. Dr. Maria Siemionow led the surgical team, which took turns at the operating table so the doctors could rest, sleep and share expertise. The woman’s identity was not disclosed, nor was the cause of her injury or the donor’s identity.

The woman is eventually expected to eat, speak and breathe normally and even smell again, her doctors said at a news conference. Feeling should return to her face in six months, and most facial functions in about a year, leading to her ability to smile after physical therapy to help train the muscles for that function. But because facial structure varies among people, the woman is not expected to look like her donor, the doctors said.

The woman will need to take antirejection drugs for the rest of her life, but those drugs do not guarantee success. Although rejection reactions seem more common in the first few months, they can occur at any time. Doctors can often reverse such reactions by adjusting the drug regimen.  The woman has cleared the earliest hurdle: she has not rejected the new face. The doctors said she was doing well but emphasized that they could not predict the future, as she faces potential complications like infections and cancers resulting from the immunosuppression treatment.  The clinic team said that if the transplant ever failed, it would be replaced with a skin graft taken from parts of the woman’s body. . . .

Continue reading

December 17, 2008 | Permalink | Comments (0) | TrackBack (0)

Saturday, December 13, 2008

Party Tips from Evolutionary Psychologists

Just in time for the holiday party season, an evolutionary psychologist provides helpful tips on how to meet a romantic partner at a party.  The LA Times reports the tips and states,

Mistletoe Wondering what to wear at the holiday party to lure a new love for '09? That expensive, sequiny dress? A handsome new holly-green vest and some knock-'em-dead after-shave? Too bad fashion writers don't read science journals. Instead of just lecturing on clothing, perfume and makeup, they could draw on research from human mating for their tips on boosting one's attractiveness at holiday parties -- ones that don't involve buying a thing.

Details such as the color of the walls, who you stand next to, whether the crab cakes at the buffet run out early -- strange to say -- may change how others perceive us in small (yet potentially useful) ways. "People are differentially attractive under different circumstances," says David M. Buss, an evolutionary psychologist at the University of Texas at Austin and author of "The Evolution of Desire."

So we trawled the scientific journals to find holiday party mating strategies that draw upon this fact. Here are the fruits: arcane tips for maximizing your irresistibility at parties this month, no expensive bling required. (Apologies to some up front: Most of the experiments we found focus on the attractiveness of heterosexual women.) . . .

I do not want to be a downer here but most of these tips seem rather offensive to me and focus only on appearance.   While first impressions are important, I am not sure that finding your partner should focus so exclusively on some of the factors mentioned.  I honestly do not believe that I could tell you what my husband was eating, where he was standing or whether he had shaved recently when we first met.   

December 13, 2008 | Permalink | Comments (0) | TrackBack (0)

Friday, December 12, 2008

Extra Frozen Embryos

William Saleton in Slate.com writes about the ethical issues surrounding extra frozen embryos and states,

President Bush, God bless him, wants to find homes for them. He wants the parents who made them to let others gestate, deliver, and raise them. It's a beautiful thought. But a survey published last week in Fertility and Sterility says it's not going to happen. The survey sampled more than 1,000 people who had embryos on ice. Only 7 percent said they were very likely to give their embryos to other parents. Twice as many were willing to consider donating embryos for research as for reproduction.

Why? Because we don't want other people raising our kids. In the survey, the authors found that "concern about or responsibility for the health or welfare of the embryo or the child it could become … was negatively associated with reproductive donation and positively associated with options not resulting in a child." For these people, the "sense of responsibility precludes their allowing their embryos to become children in any family except their own."  . . .

Imploring these people to embrace a baby-making "culture of life" is noble, but it isn't realistic. Nor is putting ads in church newsletters for 500,000 adoptive wombs. The realistic answer is to stop making and freezing so many extra embryos in the first place. That, too, requires moral strength. If you can't stand to become a parent to a batch of frozen embryos, why are you creating them? Sort out your ethics before you cross that line.

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December 12, 2008 | Permalink | Comments (0) | TrackBack (0)

New Statement from Vatican on Reproductive Technologies

Vatican The Washington Post reports today on the Vatican's new statement on various reproductive technologies.  Michelle Boorstein and Rob Stein state in their article,

The Vatican, in its first authoritative statement on reproductive science in more than 20 years, today condemned human cloning, designer babies, embryonic stem cell research that destroys human embryos and a host of techniques widely used to help infertile couples.  The sweeping 32-page document, which comes from the Catholic Church's highest rule-making authority and has the approval of Pope Benedict, warns about the moral dangers of a variety of procedures, including the freezing of unfertilized eggs and embryos, the injection of sperm directly into eggs, and the genetic testing of embryos to identify those with defects.

Although many of the arguments in "Dignitas Personae" -- Latin for "the dignity of a person" -- have been made before by Benedict and his predecessor, Pope John Paul, in public comments or writings, a church "instruction" from the Congregation for the Doctrine of the Faith is far more authoritative. It reflects the Vatican's desire to focus attention on ethical questions raised by technologies that are becoming increasingly commonplace in the United States and elsewhere.

In addition to influencing Catholic doctors, patients and researchers, the document could spur debate among non-Catholics and possibly play a role in current political debates. Barack Obama, for example, has promised to end restrictions on federal funding for embryonic stem cell research, and the Bush administration is finalizing a broad new federal regulation designed to protect health-care workers who object to providing therapies or care they find morally objectionable. The document does not address either of those issues directly but provides ethical guidance on both.

"It makes very clear that the church is very closely watching scientific progress and favors that progress but wants ethics to be part of that," said Richard Doerflinger of the U.S. Conference of Catholic Bishops. "The whole subject of misuse of technology to demean human dignity is a major concern." . . . .

Only a handful of Catholic experts were allowed to preview the document, and it was difficult to immediately gauge what impact it will have. Many non-Catholic bioethicists are also focused on technologies mentioned in the document, but the Catholic Church is historically a leader in the field of bioethics and is the world's largest Christian denomination.

Dignitas Personae, which is being released at an afternoon news conference in Rome, seeks to update "Donum Vitae," which came out in 1987 and focused on in-vitro fertilization. That was written by Pope Benedict -- then-Cardinal Joseph Ratzinger -- who was then head of the Congregation for the Doctrine of the Faith and has shaped its work and views.

Experts who had seen the document predicted it would trigger intense debate about embryo adoption as well as about alternative methods that have been proposed for obtaining embryonic stem cells. Those cells can be turned into any cell in the body and scientists hope to use them to treat a host of diseases. Alternative methods, which involve, for example, cells that have been altered so they could never develop into a viable embryo, deserve further research in animals, the document said . . . .

December 12, 2008 | Permalink | Comments (0) | TrackBack (0)

Amanda Peet Promotes Childhood Vaccines

Vaccines National Public Radio's Morning Edition discussed actress Amanda Peet's effort to promote the safety of childhood vaccines.  The report provides, 

Amanda Peet, who starred in films including The X-Files: I Want To Believe and Syriana, is working with Paul Offit, the chief of infectious diseases at Children's Hospital of Philadelphia. . . .

Peet says she began to investigate the safety of vaccines a couple of years ago, when she was pregnant. She says friends were urging her not to get her child vaccinated.  But her sister, who is a doctor, helped her get in touch with Offit, who had very different advice.  Peet says she was bewildered and frustrated by "the disparity between what I was hearing from other moms here in Hollywood and what I was hearing from the doctors." After her baby was born in early 2007, she decided to speak out publicly. Since then, she's been advocating vaccination through interviews, talk show appearances, and public service announcements.

But Peet says parents shouldn't look to her as a scientific expert. She defers scientific questions to Offit, who directs the Vaccine Education Center at Children's Hospital.  He's also the co-inventor of a vaccine against rotavirus, an intestinal bug that kills hundreds of thousands of children each year in developing nations. Vaccine critics say this means he can't be trusted on questions of vaccine safety.  For his part, Offit has plenty to say to people who question the safety of vaccines for things like measles, hepatitis and the flu. He's put much of it in a book called Autism's False Prophets: Bad Science, Risky Medicine and the Search for a Cure. . . .

Offit notes that this year there have been 135 cases of measles in the United States — the highest number in more than a decade. Most of the cases were children, he says, "and most of those children's parents chose not to vaccinate them, chose not to vaccinate them because they feared the MMR vaccine would cause autism, when clearly it doesn't."

December 12, 2008 | Permalink | Comments (0) | TrackBack (0)

Tuesday, December 9, 2008

Prescription Drugs and Side Effects/Risks

The Wall Street Journal's Health blog has an interesting piece on how patients may be scared away from certain drugs after having read materials from the FDA about the risk those drugs pose.  Sarah Rubenstein's writes,

In an era defined by Merck’s withdrawal of Vioxx over heart risks, there’s been a glut of new sources that aim to educate consumers about drug risks. Among them are Web sites from the FDA, Pfizer, Johnson & Johnson.  But too much information from the Web, the media, consumer groups and others has a side effect of its own. It can cause consumers to become alarmed, forget about drugs’ benefits and stop taking medications they need. The WSJ explores the issue. . . .

As a way of achieving some balance, FDA told the WSJ it plans to revamp its early-communication letters, which notify the public as soon as the FDA has a specific concern about a drug. They’ll include more info, such as the number of adverse events that have occurred in comparison to the number of people who take the drug. The Pfizer site, meanwhile, has a section titled “Understanding Risk.” Often, it says, “the benefits medicines provide to our health outweigh the potential risks.”


December 9, 2008 | Permalink | Comments (0) | TrackBack (0)

Health Care Spending and the Economy

In an op-ed in the New York Times published last Thursday, Jonathan Gruber,  professor of economics at the Massachusetts Institute of Technology and a board member of the Massachusetts Health Insurance Connector Authority, wrote about the prospects of health care spending serving as an economic stimulus.  He stated,

Images A central feature of Barack Obama’s presidential campaign was an aggressive plan to expand health insurance coverage by subsidizing low-income Americans and preventing discrimination against the ill. In recent weeks, Senators Max Baucus and Ted Kennedy have been working on a similar plan that might also require people to purchase insurance. Senators Ron Wyden and Bob Bennett are promoting a different approach that would largely replace our employer-sponsored health insurance system with new insurance-purchasing pools.

What all of these plans have in common is the goal of covering every American. And all would require major new spending in the near term — perhaps $100 billion a year or more. Given the present need to address the economic crisis, many people say the government cannot afford a big investment in health care, that these plans are going nowhere fast. But this represents a false choice, because health care reform is good for our economy.

As the country slips into what is possibly the worst downturn since the Depression, nearly all experts agree that Washington should stimulate demand with new spending. And one of the most effective ways to spend would be to give states money to enroll more people in Medicaid and the State Children’s Health Insurance Plan. This would free up state money for rebuilding roads and bridges and other public works projects — spending that could create jobs.

Health care reform can be an engine of job growth in other ways, too. Most proposals call for investments in health information technology, including the computerization of patient medical records. During the campaign, for example, Mr. Obama proposed spending $50 billion on such technology. The hope is that computerized recordkeeping, and the improved sharing of information among doctors that it would enable, would improve the quality of patient care and perhaps also lower medical costs. More immediately, it would create jobs in the technology sector. After all, somebody would need to develop the computer systems and operate them for thousands of American health care providers. . . .

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December 9, 2008 | Permalink | Comments (0) | TrackBack (0)

Saturday, December 6, 2008

British Health Care v. American Health Care

Ezra Klein takes on Andrew Sullivan on health care and which system, the British or American, provides better results.  It is quite a fun read.  Here is Andrew Sullivan's view on why the British are more satisfied with their health care services,

Satisfaction is a subjective function of subjective expectations. If you have the kind of expectations that many Brits have for their healthcare system, it is not hard to feel satisfied. The Brits are very happy with their dentists as well. And there is a cultural aspect here - Brits simply believe suffering is an important part of life, especially through ill health. Going to the doctor is often viewed as a moral failure, a sign of weakness. This is a cultural function of decades of conditioning that success is morally problematic and that translating that success into better health is morally inexcusable. But if most Americans with insurance had to live under the NHS for a day, there would be a revolution. It was one of my first epiphanies about most Americans: they believe in demanding and expecting the best from healthcare, not enduring and surviving the worst, because it is their collective obligation. Ah, I thought. This is how free people think and act. Which, for much of the left, is, of course, the problem.

Ezra Klein responds,

Then we could ask the question: Do the Brits seems to be in worse health? Do they have a health care system that delivers worse outcomes? The answer to both is no. In the case of ill health, they're actually in much better health than their American counterparts, though that's a function of lifestyle more than hospital choice. And in the case of health outcomes, it sort of depends. You're probably better off getting your breast cancer treated in America and getting your diabetes treated in Britain. In the aggregate, however, the evidence is fairly clear that the British are better off. Health researchers look at a measure called “amenable mortality,” which refers "to deaths from certain causes that should not occur in the presence of timely and effective health care." In other words, deaths that are prevented by contact with the health care system. If Andrew is right that those stoic Brits just grit their teeth and bear their illness, this measure should be much higher in Britain than in the US.

But it's not. In concert with Andrew's thesis, Britain does indeed have a high rate of amenable deaths. Just not higher than ours. . . . But either way, the difference between the American and British health care systems is not that we are enjoying timely and lifesaving interventions while they are forgoing them.

He further adds,

. . . the correct question is not whether Americans would want the National Health Service. The question is whether they'd want the National Health Service and a $4,000 check every year. 10 years under the British health system, and Americans would have an extra $40,000 per person (more if you account for inflation and spending growth). That's the choice. The British choose a more restrictive health care system -- and yes, the word is choose, they could vote to dismantle it, or fund it differently -- because that gives them a cheaper health care system. And I'm much less certain than Andrew that my countrymen have made some sort of explicit decision to demand the right to pay $4,000 more than the British for care that is not measurably better. responds,


December 6, 2008 | Permalink | Comments (0) | TrackBack (0)

Friday, December 5, 2008

Health Reform Moving Forward

The Wall Street Journal reports today that health reform is still alive - even as we see the economy worsen.  Laura Meckler writes,

Former Sen. Tom Daschle, who is slated to oversee health-care policy in the Obama administration, is kicking off the effort to pass a comprehensive health-care plan. In a speech to be delivered Friday in Denver, Mr. Daschle will say, "The president-elect made health-care reform one of his top priorities of his campaign, and I am here to tell you that his commitment to changing the health-care system remains strong and focused."

Mr. Daschle will emphasize the importance of moving forward even amid the economic crisis, noting that rising health-care costs put more pressure on businesses and must be addressed. The speech does not lay out any specific timetables for action on health care by the Obama administration.

Mr. Daschle, who Obama transition officials say will be nominated secretary of Health and Human Services, will suggest that Americans hold holiday-season house parties to brainstorm over how best to overhaul the U.S. health-care system. He will promise to drop by one such party himself, and to take the ideas generated to President-elect Barack Obama. . . .

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December 5, 2008 | Permalink | Comments (0) | TrackBack (0)

New Report Finds No Link Between Abortion/Depression

Thinkprogress has a short story summarizing the report from Johns Hopkins University that finds no scientific support for claims that abortions cause "psychological distress, or a 'post-abortion syndrome.'" Yahoo News reports further on the study, stating

No high-quality study done to date can document that having an abortion causes psychological distress, or a "post-abortion syndrome," and efforts to show it does occur appear to be politically motivated, U.S. researchers said on Thursday.

                        

A team at Johns Hopkins University in Baltimore reviewed 21 studies involving more than 150,000 women and found the high-quality studies showed no significant differences in long-term mental health between women who choose to abort a pregnancy and others.

                        

"The best research does not support the existence of a 'post-abortion syndrome' similar to post-traumatic stress disorder," Dr. Robert Blum, who led the study published in the journal Contraception, said in a statement.

                        

"Based on the best available evidence, emotional harm should not be a factor in abortion policy. If the goal is to help women, program and policy decisions should not distort science to advance political agendas," added Vignetta Charles, a researcher and doctoral student at Johns Hopkins who worked on the study.

December 5, 2008 | Permalink | Comments (0) | TrackBack (0)

Thursday, December 4, 2008

Flu Advice From Cell Phone

The Associated Press is reporting on a new cell phone feature - warnings about the flu virus.  The AP states,

A maker of over-the-counter cold and flu remedies released a program this week for the T-Mobile G1, also known as the "Google phone," that warns the user how many people in an area are sneezing and shaking with winter viruses.

The "Zicam Cold & Flu Companion" will say, for instance, that 8 percent to 14 percent of the people in your ZIP code have respiratory illnesses, representing a "Moderate" risk level. To give germophobes and hypochondriacs even more of a thrill, it also says what symptoms are common, like coughing and sore throatMatrixx Initiatives Inc., the Arizona company that makes products under the Zicam brand, gets the information on disease levels from Surveillance Data Inc. — which gets its data from polling health care providers and pharmacies. . . .

Google Inc., which created the G1's operating system, launched its own state-by-state Web-based flu tracker recently. It's based on the number of people plugging flu-related searches into Google's search engine.

December 4, 2008 | Permalink | Comments (0) | TrackBack (0)

YouTube Medical Device Ads: Violation of FDA Rules?

Yesterday's Wall Street Journal's Health Blog ran a short post on the use of YouTube videos to advertise medical devices and challenges to those ads by Prescription Project, an advocacy group backed in part by the Pew Charitable Trust.  I must admit in my YouTube searches the term medical device has never been of great interest, however, it must be for some because companies are using YouTube to advertise their products.  Jonathon Rockoff reports,   

Youtube_2 The Prescription Project says YouTube videos for medical devices made by Abbott, Medtronic and Stryker violate federal rules because they don’t contain required warnings and disclosures. And the group wants the FDA to do something about them.

The companies tout the virtues of the devices without also stipulating the risks that patients need to know before deciding whether to use the products, Allan Coukell, the Prescription Project’s director of policy, told the Health Blog. . . .

The Prescription Project urged the FDA, which has warned some drugmakers about Internet ads, to update its advertising rules to specifically apply to the growing role of on-line marketing. . . .

December 4, 2008 | Permalink | Comments (0) | TrackBack (0)

Wednesday, December 3, 2008

Residency Bad for Patients

Ezra Klein has a great post on the need to reform residency programs.  He writes,

Images_2 Being a medical resident is bad job. 80-hour workweeks, . . .

But being the patient of a medical resident is arguably worse. A tired doctor makes mistakes. And mistakes can kill you. Which is why I have so little patience for the caterwauling around new rules meant to impose some minimal regulations on how hard residents work. How minimal? 16-hour workdays. And the next one can start after a five hour nap period. Of course, this is merely an Institute of Medicine report making these recommendations, and thus it's not binding, and won't be enforced. And so patients will die, and medical malpractice premiums will rise, and doctors will complain, and all so we can keep this bizarre program that understands apprenticeship as a mixture of masochism and cost-cutting.

December 3, 2008 | Permalink | Comments (0) | TrackBack (0)

NICE's Cost/Benefit Analysis

The New York Times' Gardiner Harris reports on the balancing of costs and benefits of drugs in England and impact that has on other countries as all try to cope with the rising drug prices.  He writes,

Images When Bruce Hardy’s kidney cancer spread to his lung, his doctor recommended an expensive new pill from Pfizer. But Mr. Hardy is British, and the British health authorities refused to buy the medicine. His wife has been distraught. . . . 

If the Hardys lived in the United States or just about any European country other than Britain, Mr. Hardy would most likely get the drug, although he might have to pay part of the cost. A clinical trial showed that the pill, called Sutent, delays cancer progression for six months at an estimated treatment cost of $54,000.  But at that price, Mr. Hardy’s life is not worth prolonging, according to a British government agency, the National Institute for Health and Clinical Excellence. The institute, known as NICE, has decided that Britain, except in rare cases, can afford only £15,000, or about $22,750, to save six months of a citizen’s life.  British authorities, after a storm of protest, are reconsidering their decision on the cancer drug and others.

For years, Britain was almost alone in using evidence of cost-effectiveness to decide what to pay for. But skyrocketing prices for drugs and medical devices have led a growing number of countries to ask the hardest of questions: How much is life worth? For many, NICE has the answer.  Top health officials in Austria, Brazil, Colombia and Thailand said in interviews that NICE now strongly influences their policies.  “All the middle-income countries — in Eastern Europe, Central and South America, the Middle East and all over Asia — are aware of NICE and are thinking about setting up something similar,” said Dr. Andreas Seiter, a senior health specialist at the World Bank.

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December 3, 2008 | Permalink | Comments (0) | TrackBack (0)

Tuesday, December 2, 2008

Wheelchair Freedom

An editorial in today's Washington Post discusses the author's years in a wheelchair and the freedom it has provided him.  Gary Presley writes,

Images This month I began my 50th year of riding a wheelchair through life. In case you're wondering, everything is all right down here.  That's what I found myself thinking recently as I sailed through a shopping mall. "Look, Mikey! It's magic!" a tiny girl exclaimed to an even tinier boy as she spotted me. It was a reminder that most of the creatures I greet at eye level are either small children or large dogs, two of the better examples of God's work.

What that little girl believed about my power wheelchair was true for her and true for me. It is a magical thing. This one, my seventh, I call Little Red. She is a sturdy tool, very different from the fragile roll-about I came home with from the rehabilitation center five decades ago, having been left nearly quadriplegic by polio. Little Red is 10 years old, chipped and nicked and bent, but so powerful, so reliable, that the phrase "confined to a wheelchair" is not only demeaning but inaccurate. The wheelchair is freedom. . . .

Yes, everything is all right down here, "boob-high to the world," as my wife calls the place I occupy. Of course, like almost everyone else, I ache in spots I didn't 20 or 30 years ago, and I'm always a little short of money. But I have no reason to complain. I find the world growing a little friendlier each day. Architects and builders are talking about universal design, a concept that could turn a visit to a friend's house into something other than a ramp-toting expedition. President Bush signed the ADA Amendments Act, which clarifies and broadens the definition of disability to better protect people with disabilities from employment discrimination. We're making headway in corporate America, in entertainment and in politics: more visible and accepted, a few more of us productively employed. . . .

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December 2, 2008 | Permalink | Comments (0) | TrackBack (0)