A "Queen of Hearts" trial of organ markets: why Scheper-Hughes's objections to markets in human organs fail.
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Nancy Scheper-Hughes is one of the most prominent critics of markets in human organs. Unfortunately, Scheper-Hughes rejects the view that markets should be used to solve the current (and chronic) shortage of transplant organs without engaging with the arguments in favour of them. Scheper-Hughes's rejection of such markets is of especial concern, given her influence over their future, for she holds, among other positions, the status of an adviser to the World Health Organization (Geneva) on issues related to global transplantation. Given her influence, it is important that Scheper-Hughes's moral condemnation of markets in human organs be subject to critical assessment. Such critical assessment, however, has not generally been forthcoming. A careful examination of Scheper-Hughes's anti-market stance shows that it is based on serious mischaracterisations of both the pro-market position and the medical and economic realities that underlie it. In this paper, the author will expose and correct these mischaracterisations and, in so doing, show that her objections to markets in human organs are unfounded. (+info)
Achieving the National Quality Forum's "Never Events": prevention of wrong site, wrong procedure, and wrong patient operations.
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OBJECTIVE: Review the evidence regarding methods to prevent wrong site operations and present a framework that healthcare organizations can use to evaluate whether they have reduced the probability of wrong site, wrong procedure, and wrong patient operations. SUMMARY BACKGROUND DATA: Operations involving the wrong site, patient, and procedure continue despite national efforts by regulators and professional organizations. Little is known about effective policies to reduce these "never events," and healthcare professional's knowledge or appropriate use of these policies to mitigate events. METHODS: A literature review of the evidence was performed using PubMed and Google; key words used were wrong site surgery, wrong side surgery, wrong patient surgery, and wrong procedure surgery. The framework to evaluate safety includes assessing if a behaviorally specific policy or procedure exists, whether staff knows about the policy, and whether the policy is being used appropriately. RESULTS: Higher-level policies or programs have been implemented by the American Academy of Orthopaedic Surgery, Joint Commission on Accreditation of Healthcare Organizations, Veteran's Health Administration, Canadian Orthopaedic, and the North American Spine Society Associations to reduce wrong site surgery. No scientific evidence is available to guide hospitals in evaluating whether they have an effective policy, and whether staff know of the policy and appropriately use the policy to prevent "never events." CONCLUSIONS: There is limited evidence of behavioral interventions to reduce wrong site, patient, and surgical procedures. We have outlined a framework of measures that healthcare organizations can use to start evaluating whether they have reduced adverse events in operations. (+info)
Which medicine? Whose standard? Critical reflections on medical integration in China.
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There is a prevailing conviction that if traditional medicine (TRM) or complementary and alternative medicine (CAM) are integrated into healthcare systems, modern scientific medicine (MSM) should retain its principal status. This paper contends that this position is misguided in medical contexts where TRM is established and remains vibrant. By reflecting on the Chinese policy on three entrenched forms of TRM (Tibetan, Mongolian and Uighur medicines) in western regions of China, the paper challenges the ideology of science that lies behind the demand that all traditional forms of medicine be evaluated and reformed according to MSM standards. Tibetan medicine is used as a case study to indicate the falsity of a major premise of the scientific ideology. The conclusion is that the proper integrative system for TRM and MSM is a dual standard based system in which both TRM and MSM are free to operate according to their own medical standards. (+info)
Cardiothoracic surgery at a crossroads: the impact of disruptive technologic change.
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At the beginning of the twenty-first century, cardiothoracic surgery is arguably the most successful of all medical specialties. There are effective treatments including transplantation, for almost all cardiac and thoracic diseases that can be performed with low morbidity and mortality. Cardiothoracic surgeons have mastered technical difficulties through innovation, hard work, planning and skill. Yet in the past decade, the primacy of cardiothoracic surgery has been challenged by new technologies. This paper applies business school theories to examine how cardiothoracic surgeons might best respond to such "disruptive technologies". Otherwise well-managed business and industrial enterprises have had difficulty dealing with disruptive technological change because of well-recognized organizational impediments. Cardiothoracic surgeons must understand the characteristics of disruptive technologies and consider organizational changes that will allow the profession to better adapt to them. (+info)
Demands and challenges of modern medicine.
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Modern medicine, characterised by the enormous impact of rapid advances in science and technology, has vastly enhanced the doctor's professional capabilities and has made the practice of medicine more intellectually challenging as well as professionally satisfying. It has also made medicine more complex and demanding. In addition to having to keep pace with rapid medical advances, the doctor has to deal with 1) the issue of sorting the wheat from the chaff out of the deluge of new drugs and equipment presented to him, 2) the issue of rationing and determining priorities within the limits of finite resources, 3) the issue of appropriate response to new ethical challenges presented by the application of new technologies and 4) the issue of maintaining the human face of medicine in the context of growing presence and impact of technology. As doctors, we have the responsibility to ensure that through steadfast commitment to professionalism, through wisdom and insight we can harvest and maximise the vast potential of technology in caring for our patients. This is a challenge we must accept in the cause of our patients' welfare, the paramount concern of our professional creed. (+info)
What are the benefits and risks of fitting patients with radiofrequency identification devices.
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BACKGROUND TO THE DEBATE: In 2004, the United States Food and Drug Administration approved a radiofrequency identification (RFID) device that is implanted under the skin of the upper arm of patients and that stores the patient's medical identifier. When a scanner is passed over the device, the identifier is displayed on the screen of an RFID reader. An authorized health professional can then use the identifier to access the patient's clinical information, which is stored in a separate, secure database. Such RFID devices may have many medical benefits--such as expediting identification of patients and retrieval of their medical records. But critics of the technology have raised several concerns, including the risk of the patient's identifying information being used for nonmedical purposes. (+info)
Economic implications of potential changes to regulatory and reimbursement policies for medical devices.
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Causation and disease: effect of technology on postulates of causation.
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This paper reviews the technical developments in microbiology that led to the discovery of new infectious agents and the effect of these discoveries on establishing proof of causation. In bacteriology, these advances included the light microscope, bacterial stains, bacterial cultures, and the methods used to isolate clones. In virology, they involved the use of filters to separate viruses from bacteria, the electron microscope, the use of laboratory animals, embryonated eggs, tissue cultures to identify or grow the agent, and the recent development of molecular techniques to detect the presence of antigen in tissues. In immunology, they were based on the discovery of antibodies and of the immune response. (+info)