Archives of Pathology & Laboratory Medicine January 2020 Special Section - Contributions From the University of Mississippi Medical Center - Part 1

Archives of Pathology & Laboratory Medicine January 2020 Special Section - Contributions From the University of Mississippi Medical Center - Part 1

"Historically, the traditional humanities presented an alternative to the commercial market, seeing human value as more important than (and without equivalence to) mercantile values. More recently..."

The New Humanities

Once-robust fields are being broken up and stripped for parts.

"They differ in their social stances, too. Historically, the traditional humanities presented an alternative to the commercial market, seeing human value as more important than (and without equivalence to) mercantile values. More recently, cultural studies tends to criticize, if not directly oppose, the commercial market. Some wings of the new humanities, like the environmental humanities, have affinities with cultural studies, but others tend to be less critical, and more readily accommodate — or reproduce — mercantile values."

"Perhaps pathologists' greatest threat today is our inability to clearly explain the value equation to administrators, payors, legislators, and patients and their families."

Arch Pathol Lab Med. 2019 Dec;143(12):1440-1441. doi: 10.5858/arpa.2019-0286-ED.

Threats Remain.

Allen TC1.

Author information

1

From the Department of Pathology, University of Mississippi Medical Center, Jackson.

"Perhaps pathologists' greatest threat today is our inability to clearly explain the value equation to administrators, payors, legislators, and patients and their families."

What Is Popcorn Lung, and Can You Get It from Vaping?

In fact, "two medical articles by highly respected lung pathologists have shown, independently, similar findings of lung injury based on the examination of lung tissue biopsies from people who had a history of vaping, several of whom had a history of vaping marijuana or cannabis oils." But these weren't patients with popcorn lung. "Both teams of lung pathologists showed biopsies containing 'acute lung injury,' including 'diffuse alveolar damage' and 'organizing pneumonia.'" 

Don’t kill innovation in Medicare drugs

"Let’s not forget that the goal of federal health programs is to make people healthier. Without new specialty medicines, that won’t happen, and insurance will be just an empty gesture."

"...Hong Kong’s people will not go down without a fight."

Risky 

China’s Risky Endgame in Hong Kong

"China’s leaders must know that they will run into powerful resistance. While some initial steps will be taken in Beijing, the plan’s most substantive measures will require action on the ground in Hong Kong. And if the ongoing protests have shown anything, it is that Hong Kong’s people will not go down without a fight."

Big dope: how marijuana benefited from one of the slickest PR campaigns in history

And the medical marijuana PR campaign has its ‘torches of freedom’ moment, too. I have tracked it down to pages 18 and 19 of the February 6, 1979 issue of the Emory Wheel, the newspaper of Atlanta’s Emory University. Keith Stroup, the veteran founder and mainstay of the National Organization for the Reform of Marijuana Laws, said he and his campaign were ‘trying to get marijuana reclassified medically’ and that they would ‘be using the issue as a red herring to give marijuana a good name’. It must be the single most successful rebranding in marketing history. Millions now associate a highly dangerous drug with miracle cures, health and wellbeing. Mr Stroup, understandably, has since denied the words, but the article is still sitting in the Emory library for anyone who wants to check.

"...most of the important developments in American music spring from African American roots."

A celebration of the outsiders and outcasts who have made music great


For Gioia the music that truly matters is the kind that upsets Mom and Dad — and it almost always emerges from the dispossessed. Slaves, outlaws, criminals, poor country folk, foreign emigrants and inner-city kids aren’t hampered by genteel aesthetic strictures. Besides, while heard melodies are sweet, those never heard before can be even sweeter, albeit sometimes a bit loud or strangely syncopated. Ultimately, Gioia points out, most of the important developments in American music spring from African American roots. Spirituals, gospel choruses, ragtime, the blues, jazz, rock, hip-hop — these define our nation’s ever-changing soundscape.

J Clin Ethics. 2019 Fall;30(3):284-296.

Comprehensive Quality Assessment in Clinical Ethics.

Cunningham TV¹, Chatburn A², Coleman C³, DeRenzo EG⁴, Furfari K⁵, Frye J⁶, Glover AC⁷, Kenney M⁸, Nortjé N⁹, Malek J¹⁰, Repenshek M¹¹, Sheppard F¹², Crites JS¹³.

Author information

1

Director of Bioethics in the Kaiser Permanente Southern California Bioethics Program, in Los Angeles USA. thomas.v.cunningham @kp.org.

2

Regional Director for Ethics in the Theology and Ethics Department, Providence St. Joseph Health, in Spokane, Washington USA.

3

Senior Clinical Ethicist at the John J. Lynch, MD Center for Ethics at MedStar Washington Hospital Center in Washington, D.C. USA.

4

Assistant Director of the John J. Lynch, MD Center for Ethics at MedStar Washington Hospital Center in Washington, D.C. USA. Evan.G.DeRenzo@Medstar.net.

5

Associate Professor of Medicine, Division of Hospital Medicine, at the University of Colorado School of Medicine in Aurora, Colorado USA.

6

Senior Clinical Ethics Fellow at the Health Ethics Center, University of California-Los Angeles, in Los Angeles, California USA.

7

MD-MBA Candidate at Tufts University School of Medicine and Brandeis University Heller School for Social Policy and Management in Boston, Massachusetts USA.

8

Vice President, Ethics Integration and Education at Ascension in St. Louis, Missouri USA. matthew.kenney@ascension.org.

9

Assistant Professor in the Department of Critical Care at the University of Texas MD Anderson Cancer Center in Houston, Texas USA. NNortje@mdanderson.org.

10

Associate Professor in the Department of Medical Ethics and Health Policy at Baylor College of Medicine in Houston, Texas USA. jmalek@bcm.edu.

11

Vice President, Ethics and Church Relations at Ascension in St. Louis, Missouri USA. mark.repenshek@ ascension.org.

12

JD-MA in Bioethics and Science Policy Student at Duke University in Durham, North Carolina USA. flora.sheppard@duke.edu.

13

Co-Director of the Cleveland Fellowship in Advanced Bioethics and a Regional Bioethicist in the Center for Bioethics ath the Cleveland Clinic in Cleveland, Ohio USA. critesj@ccf.org.

Abstract

Scholars and professional organizations in bioethics describe various approaches to "quality assessment" in clinical ethics. Although much of this work represents significant contributions to the literature, it is not clear that there is a robust and shared understanding of what constitutes "quality" in clinical ethics, what activities should be measured when tracking clinical ethics work, and what metrics should be used when measuring those activities. Further, even the most robust quality assessment efforts to date are idiosyncratic, in that they represent evaluation of single activities or domains of clinical ethics activities, or a range of activities at a single hospital or healthcare system. Countering this trend, iin this article we propose a framework for moving beyond our current ways of understanding clinical ethics quality, toward comprehensive quality assessment. We first describe a way to conceptualize quality assessment as a process of measuring disparate, isolated work activities; then, we describe quality assessment in terms of tracking interconnected work activities holistically, across different levels of assessment. We conclude by inviting future efforts in quality improvement to adopt a comprehensive approach to quality assessment into their improvement practices, and offer recommendations for how the field might move in this direction.

Why Red Means Red in Almost Every Language

The confounding consistency of color categories.

This hypothesis may help resolve the old debate that Kay and Berlin kindled. But it also raises new questions: Do the color categories we perceive as infants lay the groundwork for those we perceive as adults, thereby creating commonalities that get tweaked and refined by language? Or does language commandeer color categorization during our childhoods, imposing its own order on our perceptual worlds?

Arch Pathol Lab Med. 2019 Oct;143(10):1171-1173. doi: 10.5858/arpa.2019-0290-LE.

Working to Solve the Thyroid Cytopathology Conundrum.

Allen TC¹.

Author information

1

Department of Pathology, University of Mississippi Medical Center, Jackson, Mississippi.

"But for Lenin maximal violence was the default position." #ButCommunism

Leninthink

by Gary Saul Morson

On the pernicious legacy of Vladimir Lenin.

By the same token, Lenin always insisted on the most violent solutions. Those who do not understand him mistake his ideas for those of radicals like the anarchist Peter Kropotkin, who argued that violence was permitted when necessary. That squishy formulation suggests that other solutions would be preferable. But for Lenin maximal violence was the default position. He was constantly rebuking subordinates for not using enough force, for restraining mobs from lynchings, and for hesitating to shoot randomly chosen hostages.

"Over the past two decades, the demise of the printed book has become a familiar story..."

Ode to skimming

Daisy Hildyard on reading and our attention spans

Over the past two decades, the demise of the printed book has become a familiar story: the digital medium is killing print and destroying our capacity to read long books. The end of print, we hear, will bring about eye strain, anxiety, aggression, fidgetiness, unkindness, stupidity and bad posture. This is not to overstate the case – in What We Talk About When We Talk About Books, Leah Price cites studies which correlate print-reading with voting, volunteering, donating to charity and lasting romantic relationships. She cites books and articles whose titles include “The End of Books”, “Is Google Making Us Stupid?” and The Pleasures of Reading in an Age of Distraction. Price sets out to demolish received wisdom about the differences between the page and the screen. She succeeds.

Zedd Says He Was “Permanently Banned” From China After Liking a South Park Tweet

The long-running Comedy Central series recently aired an episode satirizing China’s media censorship

"On Thursday, October 10, Zedd tweeted out that he had been 'permanently banned' from China for liking a South Park tweet celebrating the 300th episode of the long-running Comedy Central series. While it’s unclear whether this means that his music is banned from Chinese airplay or if the producer/DJ himself is banned from traveling to the country, his publicist confirmed to CNBC that news of the ban is 'true.'"

"Noise is never just about sound; it is inseparable from issues of power and powerlessness. It is a violation we can’t control..."

Why Everything Is Getting Louder

The tech industry is producing a rising din. Our bodies can’t adapt.

"Noise is never just about sound; it is inseparable from issues of power and powerlessness. It is a violation we can’t control and to which, because of our anatomy, we cannot close ourselves off. 'We have all thought of killing our neighbors at some point,' a soft-spoken scientist researching noise abatement told me."

Attn: Physicians - The case for civility

The case for civility

"The impact is spread widely. Research has shown that while 80 per cent of recipients of rudeness lose time worrying about it, and 38 per cent reduce the quality of their work, there is a 20 per cent decrease in the performance of staff who witness it. Onlookers are also half as likely to be willing to help others as a result of seeing the rudeness.

Importantly, this isn’t about blowing a full-blown tantrum of obnoxiousness. ‘It’s mild to moderate rudeness – being “a bit not nice”,’ Dr Turner said, adding that we could all do with examining whether we are at fault in how we deal with colleagues."

The Future of Artificial Intelligence: Ethics, Policy and Regulation [UCL event - 03.10.2019]

The Future of Artificial Intelligence: Ethics, Policy and Regulation [UCL event - 03.10.2019]

"It was, on the whole, a remarkable collective act of groveling."

The NBA's surrender to China shows free trade threatens more than jobs

Jeff Spross

"It was, on the whole, a remarkable collective act of groveling."

Blizzard on Pro-Hong-Kong Player’s Ban: He Can’t Go Unpunished

A Blizzard employee told the Beast: “I think that it's a flat-out lie that our relationships in China had nothing to do with the decision.”

One employee previously told the Beast of the ban, “Blizzard makes a lot of money in China, but now the company is in this awkward position where we can’t abide by our values.” 

J Clin Ethics. 2019 Fall;30(3):251-261.

Clarifying a Clinical Ethics Service's Value, the Visible and the Hidden.

Guidry-Grimes L¹, Warren M², Lipman HI³, Kent K⁴, Krishnamurthy KB⁵, Davis AM⁶, May T⁷, Jiro MC⁸, Jankowski J⁹.

Author information

1

Assistant Professor of Medical Humanities and Bioethics at the University of Arkansas for Medical Sciences in Little Rock, Arkansas, and Affiliate Faculty at the Center for Health Literacy in Little Rock, Arkansas USA. LGuidrygrimes@uams.edu.

2

Network Ethicist at Nova Scotia Health Ethics Network and an Assistant Professor in the Dalhousie University Department of Bioethics in Dalhousie, Nova Scotia, Canada.

3

Director of Bioethics at Hackensack University Medical Center and Associate Professor of Medicine at Hackensack Meridian School of Medicine at Seton Hall in Hackensack, New Jersey USA. Hannah.Lipman@Hackensack Meridian.org.

4

Cleveland Fellow in Advanced Bioethics at the Cleveland Clinic in Cleveland, Ohio USA. kentk@ccf.org.

5

Assistant Professor in Neurology at Harvard Medical School in Boston, Massachusetts, and Chair of the Ethics Committee at St. Elizabeth's Medical Center in Brighton, Massachusetts USA. Kaarkuzhali_Krishnamurthy@hms.harvard.edu.

6

Director of the Clinical Ethics Service at UNC Hospitals, and Associate Professor of Social Medicine at the UNC School of Medicine in Chapel Hill, North Carolina USA. arlene_davis@med.unc.edu.

7

Floyd and Judy Rogers Endowed Professor at the Elson S. Floyd College of Medicine, Washington State University, in Spokane, Washington USA. thomas.may@wsu.edu.

8

Bioethics Research Associate in the Northern California Regional Ethics Program, Kaiser Permanente. marycon.c.jiro@kp.org.

9

Associate Staff Bioethicist at the Center for Bioethics at the Cleveland Clinic in Cleveland, Ohio USA. jankowj@ccf.org.

Abstract

Our aim in this article is to define the difficulties that clinical ethics services encounter when they are asked to demonstrate the value a clinical ethics service (CES) could and should have for an institution and those it serves. The topic emerged out of numerous related presentations at the Un-Conference hosted by the Cleveland Clinic in August 2018 that identified challenges of articulating the value of clinical ethics work for hospital administrators. After a review these talks, it was apparent that the field of clinical ethics may be at a crisis of sorts due to increased pressure to provide explicit measures to healthcare institutions to concretely demonstrate that CESs make a valuable difference in healthcare delivery. In this article we grapple with how to satisfy the need for demonstrable value in a field in which metrics alone may not capture the scope of clinical ethics practice. We suggest that capturing the value of a CES has been difficult because the benefits of ethics consultation may be overt or attributable to the CES, but are often hidden due to the systems-level and process-oriented nature of clinical ethics work. Part of the difficulty in demonstrating the value of CESs is capturing and conveying all of the ways the integration of a CES throughout an institution positively affects patients, families, visitors, healthcare professionals, administrators, and the institution itself. Our aim is to (1) elucidate the multifaceted value added by a CES, including value that tends to be hidden and (2) suggest how to demonstrate value to others in a way that is not simplistic or reductionistic.

Neil Diamond - September Morn

Neil Diamond - September Morn

"...an elite sociotechnical imaginary of 'science to the rescue' shapes how public perspectives are heard and distinguishes what is considered to be legitimate expertise."

Soc Stud Sci. 2019 Oct 11:306312719879768. doi: 10.1177/0306312719879768. [Epub ahead of print]

'Nothing to do with the science': How an elite sociotechnical imaginary cements policy resistance to public perspectives on science and technology through the machinery of government.

Smallman M¹.

Author information

1

Department of Science and Technology Studies, University College London, UK.

Abstract

That policymakers adopt technoscientific viewpoints and lack reflexivity is a common criticism of scientific decision-making, particularly in response to moves to democratise science. Drawing on interviews with UK-based national policymakers, I argue that an elite sociotechnical imaginary of 'science to the rescue' shapes how public perspectives are heard and distinguishes what is considered to be legitimate expertise. The machinery of policy-making has become shaped around this imaginary - particularly its focus on science as a problem-solver and on social and ethical issues as 'nothing to do with the science' - and this gives this viewpoint its power, persistence and endurance. With this imaginary at the heart of policy-making machinery, regardless of the perspectives of the policymakers, alternative views of science are either forced to take the form of the elite imaginary in order to be processed, or they simply cannot be accounted for within the policy-making processes. In this way, the elite sociotechnical imaginary (and technoscientific viewpoint) is enacted, but also elicited and perpetuated, without the need for policymakers to engage with or even be aware of the imaginary underpinning their actions.