Thursday, August 30, 2018

Political affiliations: "...people liked their in-group members more because they thought that the profile-owner endorsed a specific type of morals."

 2018 Aug 29;13(8):e0202101. doi: 10.1371/journal.pone.0202101. eCollection 2018.

Seeing beyond political affiliations: The mediating role of perceived moral foundations on the partisan similarity-liking effect.

Author information

1
Department of Psychology, Santa Clara University, Santa Clara, CA, United States of America.
2
Department of Internal Medicine, University of Iowa, Iowa City, IA, United States of America.

Abstract

Decades of research have demonstrated that we like people who are more similar to us. The present research tested a potential mechanism for this similarity-liking effect in the domain of politics: the stereotype that people's political orientation reflects their morals. People believe that Democrats are more likely to endorse individualizing morals like fairness and Republicans are more likely to endorse binding morals like obedience to authority. Prior to the 2016 election, American participants (N = 314) viewed an ostensible Facebook profile that shared an article endorsing conservative ideals (pro-Trump or pro-Republican), or liberal ideals (pro-Clinton or pro-Democrat). Participants rated the favorability of the profile-owner, and completed the Moral Foundations Questionnaire for the profile-owner and themselves. As predicted, participants liked the profile-owner more when they shared political beliefs, and used political stereotypes to infer the moral foundations of the profile-owner. Additionally, the perceived moral foundation endorsement of the profile owner differentially mediated the relationship between the ideology and evaluations of the profile owner based on the party affiliation of the participant: perceived individualizing foundations mediated the relationship for Democratic participants and perceived binding foundations mediated the relationship for Republican participants. In other words, people liked their in-group members more because they thought that the profile-owner endorsed a specific type of morals. In Study 2 (N = 486), we ruled out the potential explanation that any political stereotype can account for the similarity-liking effect, replicating the results of Study 1 even when controlling for perceptions of other personality differences. Taken together, these studies highlight that there may be something unique about the perceived type of morality of political in-group and out-group members that may be contributing to the similarity-liking effect in politics.

Three ways to protect your health through preventive care

Three ways to protect your health through preventive care


• Make healthy living a lifestyle. Eating a balanced diet improves your overall health while maintaining a healthy weight. Motivate yourself and your family to eat more fruits and vegetables, drink more water, and limit processed foods.
• Being active lowers your risk of developing chronic conditions like obesity, high blood pressure, diabetes, and high cholesterol. Check out recommended guidelines to help maintain or improve your health through regular physical activity.

Wednesday, August 29, 2018

Keep Calm and Tweet On: Legal and Ethical Considerations for Pathologists Using Social Media

 2018 Aug 22. doi: 10.5858/arpa.2018-0313-SA. [Epub ahead of print]

Keep Calm and Tweet On: Legal and Ethical Considerations for Pathologists Using Social Media.

Author information

1
From the Department of Pathology, University of Arkansas for Medical Sciences, Little Rock (Dr Gardner); and Department of Pathology, University of Mississippi Medical Center, Jackson (Dr Allen).

Abstract

Recent privacy breaches by a major social media company have again raised questions from some pathologists regarding the legality and ethics of sharing pathology images on social media. The authors examined ethical principles as well as historic and legal precedents relevant to pathology medical photography. Taking and sharing photographs of pathology specimens is embedded into the culture of the specialty of pathology and has been for more than a century. In general, the pathologist who takes the photograph of a gross or microscopic specimen owns the copyright to that photograph. Patient consent is not legally or ethically required to take or use deidentified photographs of pathology specimens. Current US privacy laws (Health Insurance Portability and Accountability Act [HIPAA] of 1996) permit public sharing of deidentified pathology photographs without specific patient consent, even on social media. There is no case law of action taken against pathologists for sharing deidentified pathology images on social media or elsewhere. If there is any legal risk for pathologists or risk of patient harm in sharing pathology photographs, it is very small. The benefits of professional social media use for pathologists, patients, and society are numerous and well documented in the literature.

Obesity thins down ability to build muscle after workouts

Obesity thins down ability to build muscle after workouts 

"We show that post-workout muscle building and repair is blunted in young adults with obesity," Burd said. "This is significant because muscle building and repair after exercise has long-term implications for metabolic health and overall physical performance." 


Monday, August 27, 2018

"What, therefore, must the university teach students?"

"What, therefore, must the university teach students?

From my teacher, Dr. Gregorio Maranon, I learned that the university must create in the student that 'university spirit' that seeks the truth rather than scientific erudition, shows tolerance, cultivates scientific curiosity, respects investigation techniques, and is eager 'to invent duties' beyond those imposed by the curriculum.  Only then will the student respond to his vocation--that inner voice that calls us to a particular profession--through love of duty and efficiency in doing.  The university must also teach the student not just to be a sportsman obsessed by the 'chase for high marks,' which after all, are not of much value in professional life, but to create new tasks for himself, to be guided by sincere inclinations rather than by mere aptitude."

Felix Marti-Ibanez, MD, The Young Princes

Saturday, August 25, 2018

"Keller’s resistance has put her at the core of one of the most rancorous and longest-running controversies in science. 'It’s like the Thirty Years’ War'..."

The Nastiest Feud in Science

A Princeton geologist has endured decades of ridicule for arguing that the fifth extinction was caused not by an asteroid but by a series of colossal volcanic eruptions. But she’s reopened that debate. 

While the majority of her peers embraced the Chicxulub asteroid as the cause of the extinction, Keller remained a maligned and, until recently, lonely voice contesting it. She argues that the mass extinction was caused not by a wrong-place-wrong-time asteroid collision but by a series of colossal volcanic eruptions in a part of western India known as the Deccan Traps—a theory that was first proposed in 1978 and then abandoned by all but a small number of scientists. Her research, undertaken with specialists around the world and featured in leading scientific journals, has forced other scientists to take a second look at their data. “Gerta uncovered many things through the years that just don’t sit with the nice, simple impact story that Alvarez put together,” Andrew Kerr, a geochemist at Cardiff University, told me. “She’s made people think about a previously near-uniformly accepted model.”

Keller’s resistance has put her at the core of one of the most rancorous and longest-running controversies in science. “It’s like the Thirty Years’ War,” says Kirk Johnson, the director of the Smithsonian’s National Museum of Natural History. Impacters’ case-closed confidence belies decades of vicious infighting, with the two sides trading accusations of slander, sabotage, threats, discrimination, spurious data, and attempts to torpedo careers. “I’ve never come across anything that’s been so acrimonious,” Kerr says. “I’m almost speechless because of it.” Keller keeps a running list of insults that other scientists have hurled at her, either behind her back or to her face. She says she’s been called a “bitch” and “the most dangerous woman in the world,” who “should be stoned and burned at the stake.”

Disclosure of Individual Research Results and Incidental Findings in Biobank Research: Why We Need an Evidence-based Approach

 2016;24(1):89-95.

Disclosure of Individual Research Results and Incidental Findings in Biobank Research: Why We Need an Evidence-based Approach.

Abstract

Globally, genomic research is generating unprecedented advances in the understanding of the biology, pathogenetic mechanisms and prognostic markers of many cancers and is creating the possibility of precision (personalised) therapies. As more data are generated, it becomes increasingly necessary to determine the clinical significance of this data and to know when this data should be acted upon. The return of individual research results (IRRs) and incidental findings (IFs) from genomic research, in a well-informed and applicable manner, is becoming increasingly important and is already presenting practical challenges in Australian genetics clinics and familial clinics. This article argues for the need to develop an evidence-based approach to help frame ethical-legal responses to address these tensions – one that may offer flexible and defensible parameters to inform the management of disclosure of IRRs and IFs, safeguarding the health and wellbeing of tissue donors and allowing translational biobank genomic research to flourish.

"Spectral histopathology is based on the detection of changes in biochemical composition, rather than morphologic features, and is therefore more akin to methods such as matrix-assisted laser desorption ionization time-of-flight mass spectrometry imaging."

Ali AkalinMD, PhDAyşegül ErginPhDStanley RemiszewskiMEXinying MuBADan RazMDMax DiemPhD
From the Department of Pathology, University of Massachusetts Medical School, Worcester (Dr Akalin); CIRECA, LLC, Cambridge, Massachusetts (Drs Ergin and Diem, Mr Remiszewski, and Ms Mu); the Department of Mathematics and Statistics and Program in Bioinformatics, Boston University, Boston, Massachusetts (Ms Mu); the Division of Thoracic Surgery, City of Hope Medical Center, Duarte, California (Dr Raz); and the Department of Chemistry & Chemical Biology, Northeastern University, Boston, Massachusetts (Dr Diem).
Dr Ergin and Mr Remiszewski are employees of CIRECA, LLC. Dr Akalin, Ms Mu, and Dr Diem were paid consultants for CIRECA, LLC. Dr Raz was an unpaid consultant for CIRECA, LLC.
Corresponding author: Max Diem, PhD, CIRECA, LLC, 19 Blackstone St, Cambridge, MA 02139 (email: ).
This paper reports the results of a collaborative lung cancer study between City of Hope Cancer Center (Duarte, California) and CIRECA, LLC (Cambridge, Massachusetts), comprising 328 samples from 249 patients, that used an optical technique known as spectral histopathology (SHP) for tissue classification. Because SHP is based on a physical measurement, it renders diagnoses on a more objective and reproducible basis than methods based on assessing cell morphology and tissue architecture. This report demonstrates that SHP provides distinction of adenocarcinomas from squamous cell carcinomas of the lung with an accuracy comparable to that of immunohistochemistry and highly reliable classification of adenosquamous carcinoma. Furthermore, this report shows that SHP can be used to resolve interobserver differences in lung pathology. Spectral histopathology is based on the detection of changes in biochemical composition, rather than morphologic features, and is therefore more akin to methods such as matrix-assisted laser desorption ionization time-of-flight mass spectrometry imaging. Both matrix-assisted laser desorption ionization time-of-flight mass spectrometry and SHP imaging modalities demonstrate that changes in tissue morphologic features observed in classical pathology are accompanied by, and may be correlated to, changes in the biochemical composition at the cellular level. Thus, these imaging methods provide novel insight into biochemical changes due to disease.

No easy way to lower teen obesity rate

No easy way to lower teen obesity rate



By Allen Mask, M.D., Health Team physician

Nearly 14 million children and teens in this country are obese, according to the Centers for Disease Control and Prevention. Over the last 30 years, research shows that teen obesity risen while the percentage of teens trying to lose weight has declined.
That may be due in part to a growing acceptance of different body sizes, says psychologist Dr. Leslie Heinberg of the Cleveland Clinic.
"That's a good thing," she said. "Where the flip side of that may be is that there could be less motivation to make changes when changes are needed, when people are having deleterious health effects because of their weight."

Obesity may be linked to more sick leave days ("...as a coping strategy most commonly seen in women than men who may generally be less bothered about their weight.")

Obesity may be linked to more sick leave days


"This change in the number of sick leave days was viewed largely to be due to excess weight (overweight or obese) and its associated effects such as low self-esteem, body shaming, emotional distress, psychological torture of weight stigma, depression, and other disabilities relating to obesity. The authors propose that this could result in more frequent and prolonged sick leave periods as a coping strategy most commonly seen in women than men who may generally be less bothered about their weight."

Association of Reported Concern About Increasing Societal Discrimination With Adverse Behavioral Health Outcomes in Late Adolescence

 2018 Aug 20. doi: 10.1001/jamapediatrics.2018.2022. [Epub ahead of print]

Association of Reported Concern About Increasing Societal Discrimination With Adverse Behavioral Health Outcomes in Late Adolescence.

Author information

1
Department of Preventive Medicine, Keck School of Medicine, University of Southern California (USC), Los Angeles.
2
Department of Psychology, USC, Los Angeles.
3
USC Norris Comprehensive Cancer Center, Los Angeles.
4
Department of Sociology, University of North Carolina at Chapel Hill, Chapel Hill.

Abstract

IMPORTANCE:

Public expressions of discrimination may generate stress and behavioral health problems, particularly in racial/ethnic minority or socioeconomically disadvantaged youths.

OBJECTIVES:

To determine whether concern about increasing discrimination in society reported among adolescents during 2016 and the magnitude of increase in concern from 2016 to 2017 were associated with behavioral health outcomes by 2017 and to examine racial/ethnic or socioeconomic differences in associations.

DESIGN, SETTING, AND PARTICIPANTS:

This prospective cohort survey collected data at baseline from January 2 through September 28, 2016 (11th grade), and at follow-up from January 1 through August 10, 2017 (12th grade), at 10 high schools in Los Angeles, California, recruited through convenience sampling. A total of 2572 students completed both surveys.

EXPOSURES:

Reported concern, worry, or stress regarding "increasing hostility and discrimination of people because of their race, ethnicity, sexual orientation/identity, immigrant status, religion, or disability status in society" were scored as "not at all" (0) to "extremely" (4). Mean ratings were calculated in a 3-item composite (range, 0-4).

MAIN OUTCOMES AND MEASURES:

Self-reported days of cigarette, alcohol, or marijuana use in the past month (range, 0-30 days), number of substances used in the past 6 months (range, 0-27), mild to moderate depression (yes or no), and attention-deficit/hyperactivity disorder (ADHD) (yes or no) at follow-up.

RESULTS:

The sample of 2572 students (54.4% female; mean [SD] baseline age, 17.1 [0.4] years; 1969 [87.7%] had at least 1 parent with high school diploma) included 2530 with race/ethnicity data (1198 [47.4%] Hispanic; 482 [19.0%] Asian; 104 [4.1%] African American; 155 [6.1%] multiracial; 419 [16.6%] white; 172 [6.8%] other). Appreciable numbers of students reported feeling very or extremely concerned (baseline, 1047 [41.5%]; follow-up, 1028 [44.6%]), worried (baseline, 743 [29.7%]; follow-up, 795 [34.7%]), or stressed (baseline, 345 [13.9%]; follow-up, 353 [15.5%]) about increasing societal discrimination. Each 1-SD increase on the societal discrimination concern composite in 2016 was associated with more days of past-month cigarette (incidence rate ratio [IRR], 1.77; 95% CI, 1.42-2.20; P < .001), marijuana (IRR, 1.13; 95% CI, 1.01-1.26; P = .03), and alcohol (IRR, 1.11; 95% CI, 1.02-1.21; P = .01) use, more substances used (IRR, 1.07; 95% CI, 1.01-1.17; P = .04), and greater odds of depression (odds ratio [OR], 1.11; 95% CI, 1.01-1.23; P = .04) and ADHD (OR, 1.12; 95% CI, 1.01-1.26; P = .04) symptoms in 2017. The magnitude of increase in societal discrimination concern from 2016 to 2017 was also associated with several behavioral health problems in 2017; some associations were amplified among teenagers who were African American (IRR for cigarette smoking, 2.97; 95% CI, 1.45-6.09) or Hispanic (IRR for cigarette smoking, 1.30; 95% CI, 1.09-1.54) or had parents with less educational attainment (IRR for alcohol use, 1.41 [95% CI, 1.14-1.74]; OR for ADHD, 1.81 [95% CI, 1.13-2.89]).

CONCLUSIONS AND RELEVANCE:

Concern over societal discrimination was common among youths in Los Angeles in 2016 and was associated with behavioral health problems 1 year later. Adolescents' behavioral responses to recent societal expressions of discrimination may warrant public health attention.

Friday, August 24, 2018

Doctrines and Dimensions of Justice: Their Historical Backgrounds and Ideological Underpinnings

 2018 Apr;27(2):188-216. doi: 10.1017/S096318011700055X.

Doctrines and Dimensions of Justice: Their Historical Backgrounds and Ideological Underpinnings.

Abstract

Justice can be approached from many angles in ethical and political debates, including those involving healthcare, biomedical research, and well-being. The main doctrines of justice are liberal egalitarianism, libertarianism, luck egalitarianism, socialism, utilitarianism, capability approach, communitarianism, and care ethics. These can be further elaborated in the light of traditional moral and social theories, values, ideals, and interests, and there are distinct dimensions of justice that are captured better by some tactics than by others. In this article, questions surrounding these matters are approached with the hermeneutic idea of a distinction between "American" and "European" ways of thinking.

Study says no safe level of alcohol


Study says no safe level of alcohol


Among men, drinking alcohol in 2016 was most widespread in Denmark (97 per cent), along with Norway, Argentina, Germany, and Poland (94 per cent). 

In Asia, South Korean men took the lead, with 91 per cent hitting the bottle at least once in a while.
Among women, Danes also ranked first (95 per cent), followed by Norway (91 per cent), Germany and Argentina (90 per cent), and New Zealand (89 per cent).

The biggest drinkers, however, were found elsewhere.

Men in Romania who partake knocked back a top-scoring eight drinks a day on average, with Portugal, Luxembourg, Lithuania and Ukraine just behind at seven ‘units’ per day.

Ukranian women who drink were in a league of their own, putting away more than four glasses or shots every 24 hours, followed by Andorra, Luxembourg, Belarus, Sweden, Denmark, Ireland and Britain, all averaging about three per day.

From Deepali Jain and Sinchita Roy-Chowdhuri: Molecular Pathology of Lung Cancer Cytology Specimens: A Concise Review

Deepali JainMD, FIACSinchita Roy-ChowdhuriMD, PhD
From the Department of Pathology, All India Institute of Medical Sciences, New Delhi (Dr Jain); and the Division of Pathology and Laboratory Medicine, Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston (Dr Roy-Chowdhuri).
The authors have no relevant financial interest in the products or companies described in this article.
Corresponding author: Sinchita Roy-Chowdhuri, MD, PhD, Department of Pathology, Division of Pathology and Laboratory Medicine, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Unit 85, Houston, TX 77030 (email: ).
Context.— There has been a paradigm shift in the understanding of molecular pathogenesis of lung cancer. A number of oncogenic drivers have been identified in non–small cell lung carcinoma, such as the epidermal growth factor receptor (EGFR) mutation and anaplastic lymphoma kinase (ALK) gene rearrangement. Because of the clinical presentation at an advanced stage of disease in non-small cell lung carcinoma patients, the use of minimally invasive techniques is preferred to obtain a tumor sample for diagnosis. These techniques include image-guided biopsies and fine-needle aspirations, and frequently the cytology specimen may be the only tissue sample available for the diagnosis and molecular testing for these patients.
Objective.— To review the current literature and evaluate the role of cytology specimens in lung cancer mutation testing. We reviewed the types of specimens received in the laboratory, specimen processing, the effect of preanalytic factors on downstream molecular studies, and the commonly used molecular techniques for biomarker testing in lung cancer.
Data Sources.— PubMed and Google search engines were used to review the published literature on the topic.
Conclusions.— Mutation testing is feasible on a variety of cytologic specimen types and preparations. However, a thorough understanding of the cytology workflow for the processing of samples and appropriate background knowledge of the molecular tests are necessary for triaging, and optimum use of these specimens is necessary to guide patient management.

"Durable and ever-present, the Belmont Report, which is the foundational document that reset the ethics of human subject research, must now reckon with all-important novel issues of the day that could not have been foreseen by its drafters."

 2018 Aug 23:e1-e4. doi: 10.2105/AJPH.2018.304580. [Epub ahead of print]

The Belmont Report at 40: Reckoning With Time.

Author information

1
Eli Y. Adashi is with the Warren Alpert Medical School, Brown University, RI. LeRoy B. Walters is with the Kennedy Institute of Ethics and Department of Philosophy, Georgetown University, Washington, DC. Jerry A. Menikoff is with the Office for Human Research Protections, Department of Health and Human Services, Rockville, MD.

Abstract

It was the summer of 1972 when a stunned nation first learned of the infamous Tuskegee Syphilis Study, during which hundreds of poor, disease-stricken black men from Macon County Alabama, had been deliberately left untreated for 40 years. Coming on the heels of multiple, earlier examples of unethical human experimentation, the Tuskegee Syphilis Study made it plain that the moral foundation of human subject research was in desperate need of repair. Blind reliance on the Nuremberg Code and the Declaration of Helsinki was no longer going to suffice. It was against this backdrop that Congress resolved to act. Numerous hearings and multiple spirited discussions later, an agreement was struck to constitute the "Commission." The outgrowth of a retreat held at the Smithsonian Institution's Belmont Conference Center, the Belmont Report lays out a principled analytical framework to "guide the resolution of ethical problems arising from research involving human subjects." Durable and ever-present, the Belmont Report, which is the foundational document that reset the ethics of human subject research, must now reckon with all-important novel issues of the day that could not have been foreseen by its drafters.

"I’m an avid watcher of the BBC2 fly-on-the-wall documentary Hospital. On the show, 'the lab' is referenced quite often, but the term 'pathology' is never used. Why not?"

Changing the Perception of Pathology

Pathologists need to reach out to the general public – and the earlier, the better
By Hayley Pincott, Associate Practitioner in Oral Pathology at University Dental Hospital, Cardiff, UK

  I’m an avid watcher of the BBC2 fly-on-the-wall documentary Hospital. On the show, “the lab” is referenced quite often, but the term “pathology” is never used. Why not? And could a small change like using the word “pathology” start the ball rolling in making others aware of how much we are involved in healthcare? And could a small change like using the word “pathology” start the ball rolling in making others aware of how much we are involved in healthcare?


"It’s the end of the world as we know it, and Best Products is having a sale."

The Abandoned, Apocalyptic Architecture of One Bold 1970s Retail Chain

It’s the end of the world as we know it, and Best Products is having a sale.


"Unlike more monumental architecture of the era, no one seems to have thought to preserve these big-box stores. Describing the fate of the Houston showroom in a 2003 Metropolis article, the architectural historian Stephen Fox put it this way: “there’s not much sentiment here for preserving suburban landmarks.” Over the years the showrooms were bought and sold, remodeled and torn down."

To keep pace with medicine’s future, pathologists need to develop much better communication skills – with great urgency

Tell Me, Doctor…

To keep pace with medicine’s future, pathologists need to develop much better communication skills – with great urgency
"Our inability to interact effectively and efficiently with our patients, administrators, and non-pathologist physician colleagues is today’s greatest risk to our profession."

"...the idea that students should choose majors by trying to guess what the job market will reward several years later is often nuts."

The Humanities Are in Crisis


John McCain Will No Longer Be Treated for Brain Cancer, Family Says ("who spent more than five years as a prisoner of war in Vietnam...") HT:AB

John McCain Will No Longer Be Treated for Brain Cancer, Family Says



"who spent more than five years as a prisoner of war in Vietnam..."


HT:AB

Reduced physical activity in middle age: "...doesn't bode at all well for future health and should serve as a wake-up call to us all..."

New study reveals how we become more sedentary during middle age


The decreases were found in both men and women, however black men showed the biggest decline, usually starting as the most active but reducing their activity levels by nearly one hour daily.
Black women started as the least active and continued to have the lowest physical activity levels ten years later.
"We know higher intensity physical activity tends to decline with age. But these findings show just how much even gentle forms of activity that are part of daily routines, like casual walking, slip in midlife, which doesn't bode at all well for future health and should serve as a wake-up call to us all," said first and corresponding author Kelley Pettee Gabriel, Ph.D.

"The [University of Mississippi] Medical Center has lost one of the great ones..." Obituary of Dr. Julius Major Cruse Jr.




Dr. Cruse recently retired from the University of Mississippi Medical Center in Jackson after a professional tenure of almost fifty years where he served as Guyton Distinguished Professor of Pathology, Medicine and Microbiology, as well as Distinguished Professor of the History of Medicine. He formerly served as the first professor of immunology at the University of Mississippi in Oxford.

"The Medical Center has lost one of the great ones, and I have lost a mentor, colleague and friend," said Dr. Ralph Didlake, associate vice chancellor for academic affairs at the Medical Center. "He and I shared a passion for the history of medicine, and I was inspired by his intellectual energy, his curiosity and the integrity of his scholarship." 

Thursday, August 23, 2018

The last low whispers of our dead: when is it ethically justifiable to render a patient unconscious until death?

 2018 Aug 21. doi: 10.1007/s11017-018-9459-7. [Epub ahead of print]

The last low whispers of our dead: when is it ethically justifiable to render a patient unconscious until death?

Author information

1
The Pellegrino Center for Clinical Bioethics, The Kennedy Institute of Ethics, and the Departments of Medicine and Philosophy, Georgetown University, Washington, DC, USA. sulmasyd@georgetown.edu.

Abstract

A number of practices at the end of life can causally contribute to diminished consciousness in dying patients. Despite overlapping meanings and a confusing plethora of names in the published literature, this article distinguishes three types of clinically and ethically distinct practices: (1) double-effect sedation, (2) parsimonious direct sedation, and (3) sedation to unconsciousness and death. After exploring the concept of suffering, the value of consciousness, the philosophy of therapy, the ethical importance of intention, and the rule of double effect, these three practices are defined clearly and evaluated ethically. It is concluded that, if one is opposed to euthanasia and assisted suicide, double-effect sedation can frequently be ethically justified, that parsimonious direct sedation can be ethically justified only in extremely rare circumstances in which symptoms have already completely consumed the patient's consciousness, and that sedation to unconsciousness and death is never justifiable. The special case of sedation for existential suffering is also considered and rejected.

"...set to soar...": Obesity epidemic will fuel 30 per cent rise in heart attacks in 2035

Obesity epidemic will fuel 30 per cent rise in heart attacks in 2035


"Britain's obesity epidemic will cause heart attacks to rise by almost 30 per cent within two decades, new forecasts suggest.
The British Heart Foundation (BHF) said the number of strokes, cases of heart failure and angina is also set to soar unless radical action is taken to address unhealthy lifestyles."

Wednesday, August 22, 2018

My take on pathologist communication: “Pathologists have traditionally met every challenge that has arisen in our profession; this is merely the next in line.”

Tell Me, Doctor…

To keep pace with medicine’s future, pathologists need to develop much better communication skills – with great urgency

From @JMGardnerMD and me: Keep Calm and Tweet On: Legal and Ethical Considerations for Pathologists Using Social Media

Jerad M. GardnerMDTimothy C. AllenMD, JD
From the Department of Pathology, University of Arkansas for Medical Sciences, Little Rock (Dr Gardner); and Department of Pathology, University of Mississippi Medical Center, Jackson (Dr Allen).
The authors have no relevant financial interest in the products or companies described in this article.
Corresponding author: Jerad M. Gardner, MD, Department of Pathology, University of Arkansas for Medical Sciences, 4301 W Markham St, Slot 517, Little Rock, AR 72205 (email: ; Twitter: @JMGardnerMD).
Recent privacy breaches by a major social media company have again raised questions from some pathologists regarding the legality and ethics of sharing pathology images on social media. The authors examined ethical principles as well as historic and legal precedents relevant to pathology medical photography. Taking and sharing photographs of pathology specimens is embedded into the culture of the specialty of pathology and has been for more than a century. In general, the pathologist who takes the photograph of a gross or microscopic specimen owns the copyright to that photograph. Patient consent is not legally or ethically required to take or use deidentified photographs of pathology specimens. Current US privacy laws (Health Insurance Portability and Accountability Act [HIPAA] of 1996) permit public sharing of deidentified pathology photographs without specific patient consent, even on social media. There is no case law of action taken against pathologists for sharing deidentified pathology images on social media or elsewhere. If there is any legal risk for pathologists or risk of patient harm in sharing pathology photographs, it is very small. The benefits of professional social media use for pathologists, patients, and society are numerous and well documented in the literature.

Thursday, August 16, 2018

People are averse to machines making moral decisions ("...this aversion exists even when moral decisions have positive outcomes.")

 2018 Aug 11;181:21-34. doi: 10.1016/j.cognition.2018.08.003. [Epub ahead of print]

People are averse to machines making moral decisions.

Author information

1
Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, 235 E Cameron Ave, Chapel Hill, NC 27514, USA. Electronic address: ybigman@email.unc.edu.
2
Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, 235 E Cameron Ave, Chapel Hill, NC 27514, USA.

Abstract

Do people want autonomous machines making moral decisions? Nine studies suggest that that the answer is 'no'-in part because machines lack a complete mind. Studies 1-6 find that people are averse to machines making morally-relevant driving, legal, medical, and military decisions, and that this aversion is mediated by the perception that machines can neither fully think nor feel. Studies 5-6 find that this aversion exists even when moral decisions have positive outcomes. Studies 7-9 briefly investigate three potential routes to increasing the acceptability of machine moral decision-making: limiting the machine to an advisory role (Study 7), increasing machines' perceived experience (Study 8), and increasing machines' perceived expertise (Study 9). Although some of these routes show promise, the aversion to machine moral decision-making is difficult to eliminate. This aversion may prove challenging for the integration of autonomous technology in moral domains including medicine, the law, the military, and self-driving vehicles.

The everyday habits that increase your chances of obesity

The everyday habits that increase your chances of obesity

Wednesday, August 15, 2018

"Transfers of human body parts for treatment purposes are to be seen as sharing in another human being's misfortune rather than as giving owned objects."

 2018 Aug 13. doi: 10.1007/s11019-018-9862-x. [Epub ahead of print]

Leaving gift-giving behind: the ethical status of the human body and transplant medicine.

Author information

1
Instytut Filozofii, Uniwersytet Warszawski, Krakowskie Przedmieście 3, 00-927, Warsaw, Poland. p.w.lukow@uw.edu.pl.

Abstract

The paper argues that the idea of gift-giving and its associated imagery, which has been founding the ethics of organ transplants since the time of the first successful transplants, should be abandoned because it cannot effectively block arguments for (regulated) markets in human body parts. The imagery suggests that human bodies or their parts are transferable objects which belong to individuals. Such imagery is, however, neither a self-evident nor anthropologically unproblematic construal of the relation between a human being and their body. The paper proposes an alternative conceptualization of that relation, the identity view according to which a human being is identical with their living body. This view, which offers a new ethical perspective on some central concepts of transplant medicine and its ethical and legal standards and institutions, supports widely shared intuitive ethical judgments. On this proposal, an act of selling a human body or one of its parts is an act of trade in human beings, not in owned objects. Transfers of human body parts for treatment purposes are to be seen as sharing in another human being's misfortune rather than as giving owned objects. From the perspective of policy-making, the proposal requires, first, that informed consent for removal of transplant material be obtained from the potential benefactor. Secondly, explicit consent by the prospective benefactor is obligatory in the case of removal of transplant material from a living benefactor. Thirdly, in the case of posthumous retrieval, informed consent by the potential benefactor during their life is not ethically indispensable. Additionally, while refusal of posthumous retrieval expressed by a potential benefactor during their life must be respected, such a refusal needs ethical justification and explanation.