deaths after surgery account for up to one in five people who die in hospital each year
http://www.smh.com.au/national/health/shame-private-hospitals-over-deaths-say-surgeons-20120728-232vq.html
Anthem medical policy for ETS surgery
- Presence of medical complications or skin maceration with secondary infection; or
- Significant functional impairment, as documented in the medical record.
Botulinum toxin is considered medically necessary in the treatment of secondary hyperhidrosis when the condition is related to surgical complications and both of the following criteria are met:
- Presence of medical complications or skin maceration with secondary infection; and
- Significant functional impairment, as documented in the medical record.
Treatment of primary axillary or palmar hyperhidrosis with endoscopic thoracic sympathectomy is consideredmedically necessary in the small subset of individuals with hyperhidrosis where both of the following criteria (1 and 2) have been met:
- It has been adequately documented that all efforts at nonsurgical therapy have failed; and
- Either of the following:
- Presence of medical complications or skin maceration with secondary infection; or
- Significant functional impairment, as documented in the medical records;
http://www.anthem.com/medicalpolicies/policies/mp_pw_a050005.htm
surgeons took part in what the school termed "serious and continuing noncompliance"
2 UC Davis surgeons accused of experimenting on dying brain cancer patients | PressDemocrat.com: "surgeons took part in what the school termed "serious and continuing noncompliance""
'via Blog this'
'via Blog this'
women were persuaded to have hysterectomies - fake claims under a national insurance scheme
As if exploitation of poor Indian women as surrogate mothers and egg donors were not enough, surgeons may have removed the wombs of 7,000 healthy women in Chhattisgarh - a poor and largely rural state in central India -- to enrich themselves by making fake claims under a national insurance scheme. Officials believe that about 2,000 women were persuaded to have hysterectomies in the last six months alone.
It is alleged that doctors frightened poor women from remote areas into having surgery by telling them that they might get cancer without it. Some women even had hysterectomies for back pain. "Panic and fright left us with no option," a 31-year-old woman, who can no longer bear children, told the Hindustan Times.
"It has become a sensitive and serious problem. We are investigating whether these surgeries were being done just for the money or were genuinely needed. The government will take stern action against those found guilty," says state health minister Amar Agrawal.
The state health department plans to take legal action against 22 clinics which apparently did unnecessary surgery and has recommended that nine doctors in the private sector be deregistered. ~ BBC, July 17
http://www.bbc.co.uk/news/world-asia-india-18873716
the concept of evidence-based medicine was highly contested within Western medicine itself
http://theconversation.edu.au/attack-on-complementary-medicine-undermines-safety-8264
"He was prepared to kill people if it saved his authority from being questioned."
http://www.couriermail.com.au/news/sunday-mail/cmc-told-patient-murders-horrifying/story-e6frep2f-1226353778436
"Caesar judging Caesar" - utterly dysfunctional medical boards
In the end, the state's medical board, two-thirds of which are doctors, allowed the doctor to retain his registration to practise with one condition: he stop working in intensive care.
Ms Barber, who revealed a series of concerns to 7.30 in April about malpractice in Queensland hospitals, says it is a case of "Caesar judging Caesar".She says the review of such cases should be handled by a panel of people who are "legally minded", with the assistance of medical administrators.
"It's completely and utterly dysfunctional and if you were to look in the last 10 years, those [doctors] that actually had been struck off or completely gotten rid of as a result of their incompetence would be - you could count them on one hand. Maybe five or six," she said.
The allegations have been referred to Queensland's Crime and Misconduct Commission (CMC).
The CMC has appointed a former Supreme Court judge to examine what it calls a series of allegations and has referred material to the homicide squad.
Former MP Rob Messenger, who was instrumental in revealing the deeds of Dr Jayant Patel, says the case needs to go to a commission of inquiry "right now".
"It needs to go from an assessment stage to a full-blown investigation stage, but that investigation won't be effective unless witnesses are given protection," he said.
"And it's only a commission of inquiry that will be able to give potential witnesses the protection and confidence for them to come forward and tell the truth, tell their story."
The medical board declined 7:30's request for interview, but released a statement saying its role is to protect the public but that it must also be fair, lawful and provide natural justice to practitioners.
http://www.abc.net.au/news/2012-07-10/doctor-accused-of-ended-patients-lives-prematurely/4122522
Australian researchers played a key role in exposing the illegal marketing of the drug
DRUG company GlaxoSmithKline will pay US authorities $3 billion for fraudulently promoting drugs for diabetes and mental illness, in the largest healthcare fraud settlement in US history.
The drug company admitted it had promoted unproven use of an antidepressant, sold as Aropax here and Paxil overseas, for children, and did not disclose research linking it to suicidal thoughts.
Australian researchers played a key role in exposing the illegal marketing of the drug, revealing significant flaws in a research paper used to promote it.
Aropex ... fraudulently promoted for the treatment of diabetes and mental illness.
The company has also admitted to other such "off-label" marketing, as well as attempting to cover up the increased risk of heart problems linked to its diabetes drug, Avandia.
The head of the department of psychological medicine at the Adelaide Women's and Children's Hospital, Jon Jureidini, said it was distressing that even such record fines were a ''necessary cost of doing business''.
He and researcher Anne Tonkin outlined the ''distorted and unbalanced'' interpretation of the results of a study of Aropax use in children, published in the prestigious Journal of the American Academy of Child and Adolescent Psychiatry.
They argued the research did not show Aropax was safe and effective for depression in young people, and repeatedly asked for the paper to be withdrawn. He later worked with Australian Peter Mansfield and a bioethicist currently working in the US, Leemon McHenry, to expose the selective use of evidence in the paper revealed by internal drug company documents.
As part of the settlement GlaxoSmithKline agreed to the US prosecutor's argument that the study was "false and misleading", and had been prepared by a ghostwriter. Despite this, the journal has not retracted the article.
Professor Jureidini said while there was no evidence the company undertook the same aggressive and illegal promotion of the drug to doctors here as they did in the US, the research likely influenced prescribing.
"Thousands of children and adolescents who should not have been put on antidepressants were put on antidepressants, and we can be reasonably confident that a small but significant number of them will have been badly harmed," he said.
The drug company admitted it had promoted unproven use of an antidepressant, sold as Aropax here and Paxil overseas, for children, and did not disclose research linking it to suicidal thoughts.
Australian researchers played a key role in exposing the illegal marketing of the drug, revealing significant flaws in a research paper used to promote it.
Aropex ... fraudulently promoted for the treatment of diabetes and mental illness. The head of the department of psychological medicine at the Adelaide Women's and Children's Hospital, Jon Jureidini, said it was distressing that even such record fines were a ''necessary cost of doing business''.
He and researcher Anne Tonkin outlined the ''distorted and unbalanced'' interpretation of the results of a study of Aropax use in children, published in the prestigious Journal of the American Academy of Child and Adolescent Psychiatry.
They argued the research did not show Aropax was safe and effective for depression in young people, and repeatedly asked for the paper to be withdrawn. He later worked with Australian Peter Mansfield and a bioethicist currently working in the US, Leemon McHenry, to expose the selective use of evidence in the paper revealed by internal drug company documents.
As part of the settlement GlaxoSmithKline agreed to the US prosecutor's argument that the study was "false and misleading", and had been prepared by a ghostwriter. Despite this, the journal has not retracted the article.
Professor Jureidini said while there was no evidence the company undertook the same aggressive and illegal promotion of the drug to doctors here as they did in the US, the research likely influenced prescribing.
"Thousands of children and adolescents who should not have been put on antidepressants were put on antidepressants, and we can be reasonably confident that a small but significant number of them will have been badly harmed," he said.
Code for pharmaceutical industry ‘falls short’
t Medicines Australia said it had decided against mandating the release of all financial links to individual doctors over concerns about privacy, and because the cost of overseeing such a scheme, similar in effect to the Physician Payment Sunshine Act in the United States, would be prohibitive.
Medicines Australia CEO, Dr Brendan Shaw, said the peak body was “serious about maintaining an ethical industry that adds value to the role doctors play in treating patients and curing disease.”
He said Medicines Australia was mindful that disclosing the names of individual doctors could also trigger witch hunts. Instead, it would assemble a working group of representatives from both industries to consider ways to increase transparency.
Some medical experts said the regulatory body was moving too slowly.
“If we don’t name who we’re paying money to, then we’re not really behaving maturely in this area,” said Jon Jureidini, a Professor of Psychiatry at the University of Adelaide who played a crucial role in exposing the illegal behaviour of drug company GlaxoSmithKline in a major case in the US this week. The pharmaceutical group admitted bribing doctors and must pay US authorities $3 billion for fraudulently promoting antidepressant drugs for the treatment of children, without revealing research linking the drug to suicidal thoughts.
“We’ve got to be completely open about what money changes hands down to the dollar,” Professor Jureidini said. “The average fine in Australia is $50,000. That’s not going to hurt a drug company that’s worth hundreds of millions of dollars.”
Ian Kerridge, Associate Professor in Bioethics, and Director of the Centre for Values and Ethics and the Law in Medicine at the University of Sydney, said that although the revision “does continue the incremental improvements in transparency and control of the pharmaceutical industry … there is a continued inadequacy of any type of punishment mechanism within the code.
“And the other thing that disturbs me is the continuing failure to provide absolute transparency regarding the amount of sponsorship money or reimbursement given to individual doctors and researchers.
“Without that transparency, any type of reporting is quite meaningless. They’ve given a commitment to look at that issue, but they’ve been looking at it for an awfully long time. It’s just obfuscation, it’s delaying.”
http://theconversation.edu.au/code-for-pharmaceutical-industry-falls-short-8092
Medicines Australia CEO, Dr Brendan Shaw, said the peak body was “serious about maintaining an ethical industry that adds value to the role doctors play in treating patients and curing disease.”
He said Medicines Australia was mindful that disclosing the names of individual doctors could also trigger witch hunts. Instead, it would assemble a working group of representatives from both industries to consider ways to increase transparency.
Some medical experts said the regulatory body was moving too slowly.
“If we don’t name who we’re paying money to, then we’re not really behaving maturely in this area,” said Jon Jureidini, a Professor of Psychiatry at the University of Adelaide who played a crucial role in exposing the illegal behaviour of drug company GlaxoSmithKline in a major case in the US this week. The pharmaceutical group admitted bribing doctors and must pay US authorities $3 billion for fraudulently promoting antidepressant drugs for the treatment of children, without revealing research linking the drug to suicidal thoughts.
“We’ve got to be completely open about what money changes hands down to the dollar,” Professor Jureidini said. “The average fine in Australia is $50,000. That’s not going to hurt a drug company that’s worth hundreds of millions of dollars.”
Ian Kerridge, Associate Professor in Bioethics, and Director of the Centre for Values and Ethics and the Law in Medicine at the University of Sydney, said that although the revision “does continue the incremental improvements in transparency and control of the pharmaceutical industry … there is a continued inadequacy of any type of punishment mechanism within the code.
“And the other thing that disturbs me is the continuing failure to provide absolute transparency regarding the amount of sponsorship money or reimbursement given to individual doctors and researchers.
“Without that transparency, any type of reporting is quite meaningless. They’ve given a commitment to look at that issue, but they’ve been looking at it for an awfully long time. It’s just obfuscation, it’s delaying.”
http://theconversation.edu.au/code-for-pharmaceutical-industry-falls-short-8092
breaches of state regulations at Royal North Shore Hospital, and serious compliance issues in several other hospitals
The dangerous disposal of hazardous substances including liquid uranium and contaminated objects, the dumping of the confidential records of patients and the mishandling of asbestos have exposed a culture of mismanagement in Sydney hospitals.
A former NSW health contractor turned whistleblower is alleging that a lack of proper procedures and controls has led to breaches of state regulations at Royal North Shore Hospital, and serious compliance issues in several other hospitals.
A former NSW health contractor turned whistleblower is alleging that a lack of proper procedures and controls has led to breaches of state regulations at Royal North Shore Hospital, and serious compliance issues in several other hospitals.
Japanese doctor smashes world record for bogus research
The wonderfully informative blog Retraction Watch points out that 3 anesthesiologists – Fujii, Boldt, and an American, Scott Reuben – account for 13% of all papers retracted since 1970.
All but one of Fujii’s co-authors were unaware of his misconduct. In many cases, he included them as authors without telling them and even forged their signatures. However, the latest news comes 12 years after questions were first raised about the validity of his work.
http://www.bioedge.org/index.php/bioethics/bioethics_article/10138#comments
All but one of Fujii’s co-authors were unaware of his misconduct. In many cases, he included them as authors without telling them and even forged their signatures. However, the latest news comes 12 years after questions were first raised about the validity of his work.
http://www.bioedge.org/index.php/bioethics/bioethics_article/10138#comments
results of sympathectomy deteriorate with time
results of sympathectomy deteriorate with time (T.S. Lin & Fang, 1999; Walles et al., 2008). This recurrent postoperative sweating may be due to local nerve regeneration but has not yet been proven (Lee et al., 1999).
http://www.intechopen.com/books/topics-in-thoracic-surgery/surgical-management-of-primary-upper-limb-hyperhidrosis-a-review
http://www.intechopen.com/books/topics-in-thoracic-surgery/surgical-management-of-primary-upper-limb-hyperhidrosis-a-review
Roche is under investigation over a failure to properly report adverse drug side effects
Inspectors at the Basel-based company's British site in Welwyn found deficiencies related to Roche's global process of detecting and reporting the adverse effects of medicines.
At the time of the inspection, 80,000 reports for medicines marketed by Roche in the US had been collected through a Roche-sponsored patient support program, but had not been evaluated to determine whether they should be reported to the EU authorities as suspected adverse reactions.
"These included 15,161 reports of death of patients and it is not known whether the deaths were due to natural progression of the disease or had a causal link to the medicine," the EMA said in the statement on Thursday.
"There is, at present, no evidence of a negative impact for patients and while the investigations are being conducted there is no need for patients or health care professionals to take any action," added the EMA.
A Roche spokesman said the company acknowledges it did not fully comply with regulations and appreciates the concerns that can be caused by this issue for people using its products.
http://www.medicalobserver.com.au/news/eye-on-roche-after-failure-to-report-side-effects
At the time of the inspection, 80,000 reports for medicines marketed by Roche in the US had been collected through a Roche-sponsored patient support program, but had not been evaluated to determine whether they should be reported to the EU authorities as suspected adverse reactions.
"These included 15,161 reports of death of patients and it is not known whether the deaths were due to natural progression of the disease or had a causal link to the medicine," the EMA said in the statement on Thursday.
"There is, at present, no evidence of a negative impact for patients and while the investigations are being conducted there is no need for patients or health care professionals to take any action," added the EMA.
A Roche spokesman said the company acknowledges it did not fully comply with regulations and appreciates the concerns that can be caused by this issue for people using its products.
http://www.medicalobserver.com.au/news/eye-on-roche-after-failure-to-report-side-effects
“Doctors tend to confuse what they believe with what they know,”
http://inside.org.au/overtested-overtreated-and-over-here/
Horner syndrome, pneumothorax, hemothorax, asymmetry of results, intercostal neuralgia, causalgia, hypoesthesia, incomplete results, paresthesia in the anterolateral abdominal wall, dyspareunia
The complications and side effects are very significant, such as irreversible compensatory sweating (20% to 50%), low satisfaction with results, Claude-Bernard-Horner syndrome, pneumothorax, hemothorax, asymmetry of results, intercostal neuralgia, causalgia, incomplete results, and anesthetic complications11-13.
Retroperitoneoscopic lumbar sympathectomy (video-assisted): this technique is effective in the treatment of isolated or persistent plantar hyperhidrosis (compensatory after thoracic sympathectomy). The treatment consists of removing the nerves of the sympathetic chain located in the abdomen, in the anterolateral portion of the lumbar vertebrae. It requires hospitalization and is carried out under general anesthesia. It may lead to complications such as lesions of structures adjacent to the sympathetic chain, light abdominal distension, neuralgia, and causalgia as well as hypoesthesia in the thighs and groin, limitation of leg movement,
paresthesia in the anterolateral abdominal wall, change in libido, dyspareunia, pulmonary thromboembolism, hemorrhages, arrhythmias, and cardiac decompensation, amongst others. It definitively eliminates plantar hyperhidrosis14,15.
http://www.scielo.br/scielo.php?pid=S1983-51752011000400008&script=sci_arttext&tlng=en#end
Retroperitoneoscopic lumbar sympathectomy (video-assisted): this technique is effective in the treatment of isolated or persistent plantar hyperhidrosis (compensatory after thoracic sympathectomy). The treatment consists of removing the nerves of the sympathetic chain located in the abdomen, in the anterolateral portion of the lumbar vertebrae. It requires hospitalization and is carried out under general anesthesia. It may lead to complications such as lesions of structures adjacent to the sympathetic chain, light abdominal distension, neuralgia, and causalgia as well as hypoesthesia in the thighs and groin, limitation of leg movement,
paresthesia in the anterolateral abdominal wall, change in libido, dyspareunia, pulmonary thromboembolism, hemorrhages, arrhythmias, and cardiac decompensation, amongst others. It definitively eliminates plantar hyperhidrosis14,15.
http://www.scielo.br/scielo.php?pid=S1983-51752011000400008&script=sci_arttext&tlng=en#end
Horner syndrome, pneumothorax, hemothorax, asymmetry of results, intercostal neuralgia, causalgia, hypoesthesia, incomplete results, paresthesia in the anterolateral abdominal wall, dyspareunia
The complications and side effects are very significant, such as irreversible compensatory sweating (20% to 50%), low satisfaction with results, Claude-Bernard-Horner syndrome, pneumothorax, hemothorax, asymmetry of results, intercostal neuralgia, causalgia, incomplete results, and anesthetic complications11-13.
Retroperitoneoscopic lumbar sympathectomy (video-assisted): this technique is effective in the treatment of isolated or persistent plantar hyperhidrosis (compensatory after thoracic sympathectomy). The treatment consists of removing the nerves of the sympathetic chain located in the abdomen, in the anterolateral portion of the lumbar vertebrae. It requires hospitalization and is carried out under general anesthesia. It may lead to complications such as lesions of structures adjacent to the sympathetic chain, light abdominal distension, neuralgia, and causalgia as well as hypoesthesia in the thighs and groin, limitation of leg movement,
paresthesia in the anterolateral abdominal wall, change in libido, dyspareunia, pulmonary thromboembolism, hemorrhages, arrhythmias, and cardiac decompensation, amongst others. It definitively eliminates plantar hyperhidrosis14,15.
http://www.scielo.br/scielo.php?pid=S1983-51752011000400008&script=sci_arttext&tlng=en#end
Retroperitoneoscopic lumbar sympathectomy (video-assisted): this technique is effective in the treatment of isolated or persistent plantar hyperhidrosis (compensatory after thoracic sympathectomy). The treatment consists of removing the nerves of the sympathetic chain located in the abdomen, in the anterolateral portion of the lumbar vertebrae. It requires hospitalization and is carried out under general anesthesia. It may lead to complications such as lesions of structures adjacent to the sympathetic chain, light abdominal distension, neuralgia, and causalgia as well as hypoesthesia in the thighs and groin, limitation of leg movement,
paresthesia in the anterolateral abdominal wall, change in libido, dyspareunia, pulmonary thromboembolism, hemorrhages, arrhythmias, and cardiac decompensation, amongst others. It definitively eliminates plantar hyperhidrosis14,15.
http://www.scielo.br/scielo.php?pid=S1983-51752011000400008&script=sci_arttext&tlng=en#end
how drug marketing undermines patient safety and public health
Am J Public Health. 2011 Mar;101(3):399-404. Epub 2011 Jan 13.
The inverse benefit law: how drug marketing undermines patient safety and public health.
Recent highly publicized withdrawals of drugs from the market because of safety concerns raise the question of whether these events are random failures or part of a recurring pattern. The inverse benefit law, inspired by Hart's inverse care law, states that the ratio of benefits to harms among patients taking new drugs tends to vary inversely with how extensively the drugs are marketed. The law is manifested through
6 basic marketing strategies:
reducing thresholds for diagnosing disease,
relying on surrogate endpoints,
exaggerating safety claims,
exaggerating efficacy claims,
creating new diseases, and
encouraging unapproved uses.
The inverse benefit law highlights the need for comparative effectiveness research and other reforms to improve evidence-based prescribing.
http://www.ncbi.nlm.nih.gov/pubmed/21233426?dopt=Abstract
http://www.ncbi.nlm.nih.gov/pubmed/21233426?dopt=Abstract
disease-mongering activities companies can use to stimulate drug sales
- Promotion of anxiety about future ill-health in healthy individuals
- Inflated disease prevalence rates
- Promotion of aggressive drug treatment of milder symptoms and diseases
- Introduction of questionable new diagnoses—such as PMDD or social anxiety disorder—that are hard to distinguish from normal life
- Redefinition of diseases in terms of surrogate outcomes (i.e., osteoporosis becomes a disease of low bone density rather than fragility fractures)
- Promotion of drugs as a first-line solution for problems previously not considered medical, such as disruptive classroom behaviour or problematic sexual relationships.
The rationale for regulation of drug promotion is health protection, encouragement of appropriate medicine use, and prevention of deceptive advertising. The European community code on medicinal products for human use states that advertising of medicinal products “must encourage the rational use of the product and may not be misleading” [ 34]. Canada's Food and Drugs Act prohibits advertising of a drug that is “false, misleading or deceptive or is likely to create an erroneous impression regarding its character, value, quantity, merit or safety” [ 35]. The World Health Organization's Ethical Criteria for Medicinal Drug Promotion states that advertisements, “…should not take undue advantage of people's concern for their health” [ 36].
Disease mongering by definition creates erroneous impressions of the condition a product aims to treat and the merit and safety of treatment, and frequently provokes undue anxiety or exaggerates prevalence rates.http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1434509/?tool=pubmed
state watchdog agencies including the CMC failed to protect patients from dangerous doctors
http://m.news.com.au/QLD/pg/0/fi1554357.htm
"It is plainly not possible for a trust to be, and to be seen to be, 'independent' in investigating a death which may have been caused or contributed to by failures of its own staff or systems."
http://www.guardian.co.uk/society/2012/may/26/campaign-deaths-mental-health-patients
Sympathectomy has been discredited in this condition
Vasospastic conditions
Raynaud’s syndrome
http://surgeryonline.wordpress.com/category/arterial-disorders/
(but you would not know this by reading the websites of the many vascular surgeons offering this 'cure')
a rare move by a US panel editing the universal diagnostic manual to drop two unpopular proposals for new diagnoses
The decision to back away from a proposed diagnosis of “attenuated psychosis syndrome" – for people at risk of developing psychosis, and from “mixed anxiety depressive disorder” – for people with a mixed state of both illnesses, was a welcome respite from the relentless push to expand the boundaries of pathology, experts said.
The American Psychiatric Association panel in charge of the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM) also modified the definition of depression to ensure that people experiencing normal grief over the death of a family member or a job loss would not be included.
Professor Gordon Parker, Scentia Professor in the School of Psychiatry at the University of New South Wales, said there had been “great concern in the community over the past 10 years in particular about what you could call ‘psychiatric imperialism’ – where the boundaries of categorising psychiatric disorders has moved from the clearly pathological down into the more normal. There’s that background concern that does need to be respected.”
http://theconversation.edu.au/backdown-on-new-psychiatric-diagnoses-a-welcome-respite-7092
The American Psychiatric Association panel in charge of the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM) also modified the definition of depression to ensure that people experiencing normal grief over the death of a family member or a job loss would not be included.
Professor Gordon Parker, Scentia Professor in the School of Psychiatry at the University of New South Wales, said there had been “great concern in the community over the past 10 years in particular about what you could call ‘psychiatric imperialism’ – where the boundaries of categorising psychiatric disorders has moved from the clearly pathological down into the more normal. There’s that background concern that does need to be respected.”
http://theconversation.edu.au/backdown-on-new-psychiatric-diagnoses-a-welcome-respite-7092
major trial of epoetin misled the medical community about the anemia drug’s risks and benefits-and helped make Amgen rich
http://the-scientist.com/2012/05/14/opinion-misleading-drug-trials/
Qld doctor accused of killing patients
Police in Queensland will this week be asked to launch a murder investigation into claims a doctor killed patients.
Former independent Queensland MP Rob Messenger gave taped interviews of a former colleague of the doctor to media and the Crime and Misconduct Commission (CMC).
On the tape, the whistleblower doctor accuses his former colleague of at least two killings.
One of the incidents involved oxygen being turned down on a patient on life support, which prematurely killed the woman against her wishes.
On another occasion, a surgeon had to restrain the doctor for 15 minutes to stop him from hurting a patient.
"He was prepared to kill people if it saved his authority from being questioned," the doctor said in the recording.
Health Minister Lawrence Springborg said that the doctor was still employed by Queensland Health but had been separated from patients.
http://www.nzherald.co.nz/health/news/article.cfm?c_id=204&objectid=10805741
Former independent Queensland MP Rob Messenger gave taped interviews of a former colleague of the doctor to media and the Crime and Misconduct Commission (CMC).
On the tape, the whistleblower doctor accuses his former colleague of at least two killings.
One of the incidents involved oxygen being turned down on a patient on life support, which prematurely killed the woman against her wishes.
On another occasion, a surgeon had to restrain the doctor for 15 minutes to stop him from hurting a patient.
"He was prepared to kill people if it saved his authority from being questioned," the doctor said in the recording.
Health Minister Lawrence Springborg said that the doctor was still employed by Queensland Health but had been separated from patients.
http://www.nzherald.co.nz/health/news/article.cfm?c_id=204&objectid=10805741
Use of stellate ganglion block for the treatment of psychiatric and behavioral disorders
The present invention is directed to a method for the treatment of a patient suffering from psychiatric and behavioral disorders, including post partum depression, post traumatic stress disorder, compulsive smoking, attention deficit hyperactivity disorder, gambling addiction, comprising the step of administering a stellate ganglion block to the patient to alleviate the symptoms. The stellate ganglion block may be followed by a sympathectomy to provide permanent relief.
http://www.freepatentsonline.com/y2007/0135871.html
Kind Code: A1
The courts have become the sole policing body for the medical profession, and malpractice lawyers have taken on the role of public prosecutors
Major lawsuits, with the major judgments that go with them, may not completely keep negligent physicians from practicing, but they are the one way that currently exists to deter these individuals from practicing their inept brand of medicine. "
Over the years, we have given a lot of thought to why the medical profession adheres to this code of silence. What is it about this profession that causes it to protect its own at the expense of the public?"
Harvey F. Wachsman: Lethal Medicine
Publisher: Henry Holt & Co
Retractions (fraud) on the rise
Get Science News From The New York Times »
Source: Journal of Medical Ethics
The highest “retraction index” in the study went to one of the world’s leading medical journals, The New England Journal of Medicine. In a statement for this article, it questioned the study’s methodology, noting that it considered only papers with abstracts, which are included in a small fraction of studies published in each issue. “Because our denominator was low, the index was high,” the statement said.
In October 2011, for example, the journal Nature reported that published retractions had increased tenfold over the past decade, while the number of published papers had increased by just 44 percent. In 2010 The Journal of Medical Ethics published a study finding the new raft of recent retractions was a mix of misconduct and honest scientific mistakes.
http://www.nytimes.com/2012/04/17/science/rise-in-scientific-journal-retractions-prompts-calls-for-reform.html?_r=2&src=dayp&pagewanted=all
too many bioethicists are being funded by Big Pharma
Gadfly: a person who annoys or criticizes others in order to provoke them into action (Oxford English Dictionary). There is no better word to describe Carl Elliott, a University of Minnesota bioethicist who is probably the profession’s most savage critic. In his column in the Chronicle of Higher Education this week, he returned to a favourite theme: the dangers of cosying up to the pharmaceutical industry. He complains that too many bioethicists are being funded by Big Pharma, which Dr Elliott tends to describe as a Mafia network.
He writes:
He writes:
“If there is anything surprising about the upsurge in pharma-funded bioethics, it is that it has been accompanied by a dramatic rise in criminal behavior by the pharmaceutical industry: fraud, illegal marketing, ghostwriting, tax evasion, kickbacks, and bribery…
“Apparently, many bioethicists see nothing unseemly about sharing in profits generated by criminal activity. In fact, the bioethicists working with industry are often among the most prominent in the field. If anything, an association with the pharmaceutical industry has become a mark of professional success. What does this say about the future of bioethics?”
http://www.bioedge.org/index.php/bioethics/bioethics_article/10056
behavioral therapy, psychiatry, shock therapy
A controversy has erupted in Massachusetts over the use of skin shock therapy for troubled teenagers. The Judge Rotenberg Educational Center in the suburb of Canton is a facility for people with severe emotional, behavioural and psychiatric problems, including autism. It is the only institution in the US which uses shock therapy – a 2-second application to the skin which feels like a pinch, or, its critics say, a bee sting. About half of its 250 students are treated this way.
This week, a graphic video from 2002 showing a restrained teenager screaming in pain while staff administered 31 shocks galvanised opponents into obtaining more than 200,000 signatures on a on-line petition to state legislators – although it included only 9,000 Massachusetts residents.
The JRC claims that its intensive behavioural therapies have successfully “treated the most difficult behaviours in the nation, often children and young adults who had been confined to psychiatric hospitals because their behaviour disorders could not be effectively treated”. It argues that the shocks are only given after a court and a child’s parents have approved. The alternative, it says, is drugging children and warehousing them in a mental hospital – which is a kind of torture.
Its critics say that electric shock therapy is the kind of torture would not be allowed in a prison. They have even managed to get the Manfred Nowak, the UN's Special Rapporteur on Torture, to ask the US government to investigate the institution. "Of course here they might say, but this is for a good purpose because it is for medical treatment,” Nowak told ABC in 2010. “But even for a good purpose -- because the same is to get from a terrorist information about a future attack, is a good purpose. To get from a criminal a confession is a good purpose.
A health writer in Time magazine, Maia Szalavitz, has written a book on the troubled-teen industry. She is a bitter critic of the JRC and says that it has never published a single peer-reviewed paper which demonstrates that the technique is successful. She dismisses glowing reports from parents as mere anecdotes.
http://www.bioedge.org/index.php/bioethics/bioethics_article/10060
This week, a graphic video from 2002 showing a restrained teenager screaming in pain while staff administered 31 shocks galvanised opponents into obtaining more than 200,000 signatures on a on-line petition to state legislators – although it included only 9,000 Massachusetts residents.
The JRC founder, Matthew L. Israel, a behavioural psychologist who trained with Harvard’s B.F. Skinner, was forced to step down last year over an incident in which staff gave two teenagers dozens of shocks after receiving orders from a prank phone call.
In the heat of claim and counter-claim, it is hard to know whether the therapy is mild and helpful or severe and abusive.The JRC claims that its intensive behavioural therapies have successfully “treated the most difficult behaviours in the nation, often children and young adults who had been confined to psychiatric hospitals because their behaviour disorders could not be effectively treated”. It argues that the shocks are only given after a court and a child’s parents have approved. The alternative, it says, is drugging children and warehousing them in a mental hospital – which is a kind of torture.
Its critics say that electric shock therapy is the kind of torture would not be allowed in a prison. They have even managed to get the Manfred Nowak, the UN's Special Rapporteur on Torture, to ask the US government to investigate the institution. "Of course here they might say, but this is for a good purpose because it is for medical treatment,” Nowak told ABC in 2010. “But even for a good purpose -- because the same is to get from a terrorist information about a future attack, is a good purpose. To get from a criminal a confession is a good purpose.
A health writer in Time magazine, Maia Szalavitz, has written a book on the troubled-teen industry. She is a bitter critic of the JRC and says that it has never published a single peer-reviewed paper which demonstrates that the technique is successful. She dismisses glowing reports from parents as mere anecdotes.
http://www.bioedge.org/index.php/bioethics/bioethics_article/10060
"Alarming cracks” in the edifice of science
The New York Times highlights the belief of the editor of the journal Infection and Immunity, Ferric C. Fang, that a ten-fold increase in the number of retractions over the past ten years is a symptom of "a dysfunctional scientific climate". And in an opinion piece in Nature, the co-director of the Consortium for Science, Policy and Outcomes at Arizona State University, Daniel Sarewitz, speaks darkly of "alarming cracks" in the scientific edifice which are eroding public trust.
Dr Fang recently issued a call for root-and-branch reform in an eloquent editorial in his journal.
"The present system," he writes, "provides ... potent incentives for behaviors that are detrimental to science and scientists." "You can't afford to fail, to have your hypothesis disproven," Dr. Fang told the Times. "It's a small minority of scientists who engage in frank misconduct. It's a much more insidious thing that you feel compelled to put the best face on everything."
Dr Sarewitz also calls for change to eliminate bias. "Science's internal controls on bias [are] failing, and bias and error [are] trending in the same direction -- towards the pervasive over-selection and over-reporting of false positive results." Significantly for bioethics, he says that "the cracks in the edifice are showing up first in the biomedical realm, because research results are constantly put to the practical test of improving human health".
http://www.bioedge.org/index.php/bioethics/bioethics_article/10059
Dr Fang recently issued a call for root-and-branch reform in an eloquent editorial in his journal.
"The present system," he writes, "provides ... potent incentives for behaviors that are detrimental to science and scientists." "You can't afford to fail, to have your hypothesis disproven," Dr. Fang told the Times. "It's a small minority of scientists who engage in frank misconduct. It's a much more insidious thing that you feel compelled to put the best face on everything."
Dr Sarewitz also calls for change to eliminate bias. "Science's internal controls on bias [are] failing, and bias and error [are] trending in the same direction -- towards the pervasive over-selection and over-reporting of false positive results." Significantly for bioethics, he says that "the cracks in the edifice are showing up first in the biomedical realm, because research results are constantly put to the practical test of improving human health".
http://www.bioedge.org/index.php/bioethics/bioethics_article/10059
Number of sympathectomies - ETS - is on the increase in Australia - the power of medical advertising
years 2000 - 2001:
Total: 1034
years 2001-2002:
Total: 1575
years 2002 - 2003
Total: 1228
years 2003 - 2004
Total: 1193
years 2004 - 2005
Total: 1483
years 2005 - 2006
Total:1358
years 2006 - 2007
Total: 972
years 2007 - 2008
Total: 850
years 2008 - 2009
Total: 891
years 2009 - 2010
Total: 1083
source: aihw.gov.au
Total: 1034
years 2001-2002:
Total: 1575
years 2002 - 2003
Total: 1228
years 2003 - 2004
Total: 1193
years 2004 - 2005
Total: 1483
years 2005 - 2006
Total:1358
years 2006 - 2007
Total: 972
years 2007 - 2008
Total: 850
years 2008 - 2009
Total: 891
years 2009 - 2010
Total: 1083
source: aihw.gov.au
Sting Operation Exposes Gaps in Oversight of Human Experiments
Thousands of medical research groups that monitor clinical trials on behalf of the drug industry may face tougher regulations in the wake of a congressional sting operation that found gaps in the nation's oversight of experiments on humans.
The sting, detailed at a House Energy and Commerce Committee hearing Thursday, involved the creation of a fictitious company and a fake medical device, a surgical adhesive gel. The sham firm then applied to three for-profit oversight groups -- called institutional review boards, or IRBs -- for approval to begin a clinical trial using their adhesive on human subjects.
Two IRBs contacted by the GAO's sting operators -- Argus IRB of Arizona and Fox IRB of Illinois -- rejected the Adhesiabloc proposal because of unanswered safety questions.
Coast IRB LLC of Colorado Springs, Colo., did approve a study for the fictitious adhesive gel, "Adhesiabloc." Five months after approving the study for abdominal surgery patients, Coast learned that neither Adhesiabloc nor its maker, Device Med-Systems of Virginia, existed.
Coast CEO Dan Dueber said in an interview that the congressional case was illegal entrapment. At the hearing, Mr. Dueber testified, "The GAO perpetrated an extensive fraud against my company. You pulled the wool over our eyes -- congratulations." Because the product was fake, it was never used.
As part of the sting, the committee also created a sham IRB to see whether the Department of Health and Human Services, which registers IRBs, would certify their fictitious group.
The committee, working with the Government Accountability Office, Congress's investigatory arm, named the CEO of the fake IRB Truper Dawg, after a staffer's three-legged dog, now deceased. Other fake names included "April Phuls" and "Timothy Wittless," which lawmakers said should have signaled irregularities to HHS. The department registered the IRB.
http://online.wsj.com/article/SB123811179572353181.html
The sting, detailed at a House Energy and Commerce Committee hearing Thursday, involved the creation of a fictitious company and a fake medical device, a surgical adhesive gel. The sham firm then applied to three for-profit oversight groups -- called institutional review boards, or IRBs -- for approval to begin a clinical trial using their adhesive on human subjects.
Two IRBs contacted by the GAO's sting operators -- Argus IRB of Arizona and Fox IRB of Illinois -- rejected the Adhesiabloc proposal because of unanswered safety questions.
Coast IRB LLC of Colorado Springs, Colo., did approve a study for the fictitious adhesive gel, "Adhesiabloc." Five months after approving the study for abdominal surgery patients, Coast learned that neither Adhesiabloc nor its maker, Device Med-Systems of Virginia, existed.
Coast CEO Dan Dueber said in an interview that the congressional case was illegal entrapment. At the hearing, Mr. Dueber testified, "The GAO perpetrated an extensive fraud against my company. You pulled the wool over our eyes -- congratulations." Because the product was fake, it was never used.
As part of the sting, the committee also created a sham IRB to see whether the Department of Health and Human Services, which registers IRBs, would certify their fictitious group.
The committee, working with the Government Accountability Office, Congress's investigatory arm, named the CEO of the fake IRB Truper Dawg, after a staffer's three-legged dog, now deceased. Other fake names included "April Phuls" and "Timothy Wittless," which lawmakers said should have signaled irregularities to HHS. The department registered the IRB.
http://online.wsj.com/article/SB123811179572353181.html
it is now Dr. Wakefield's turn to be exonerated
Mr. Justice Mitting's scathing indictment of GMC's unprofessional and dishonest handling of the Dr. Wakefield case is telling, as it once again calls into question the legitimacy of any of the claims made against Dr. Wakefield and his colleagues concerning their observational, peer-reviewed study. It only further reinforces what has already come to light about the blatant fraud that is the continued witch hunt against Dr. Wakefield for his independent work.
"The welcome decision to exonerate Prof. Walker-Smith is a clear indication that the GMC's case against the Royal Free doctors was manufactured to discredit any association between bowel disease, autism conditions and some of the parents' reported link to the MMR vaccine," writes Age of Autism. "The allegations leveled at Prof. Walker-Smith and the Royal Free team now have to be viewed with total skepticism as nothing more than a witch hunt by vested interests at the highest levels in government, media and the pharmaceutical industry."
This ruling will clearly bolster the efforts of Dr. Wakefield to vindicate his own reputation and career, including his recent lawsuit against Brian Deer, BMJ, and BMJ editor Fiona Godlee, all of which have repeatedly spread lies and slander about Dr. Wakefield and his paper (http://www.naturalnews.com/034974_Andrew_Wakefield_BMJ_lawsuit.html).
Learn more: http://www.naturalnews.com/035256_Professor_Walker-Smith_MMR_vaccines_High_Court.html#ixzz1uFbANzgz
"The welcome decision to exonerate Prof. Walker-Smith is a clear indication that the GMC's case against the Royal Free doctors was manufactured to discredit any association between bowel disease, autism conditions and some of the parents' reported link to the MMR vaccine," writes Age of Autism. "The allegations leveled at Prof. Walker-Smith and the Royal Free team now have to be viewed with total skepticism as nothing more than a witch hunt by vested interests at the highest levels in government, media and the pharmaceutical industry."
This ruling will clearly bolster the efforts of Dr. Wakefield to vindicate his own reputation and career, including his recent lawsuit against Brian Deer, BMJ, and BMJ editor Fiona Godlee, all of which have repeatedly spread lies and slander about Dr. Wakefield and his paper (http://www.naturalnews.com/034974_Andrew_Wakefield_BMJ_lawsuit.html).
Learn more: http://www.naturalnews.com/035256_Professor_Walker-Smith_MMR_vaccines_High_Court.html#ixzz1uFbANzgz
The participation of physicians in torture and murder both before and after World War II is a disturbing legacy
More than 7% of all German physicians became members of the Nazi SS during World War II, compared with less than 1% of the general population. In so doing, these doctors willingly participated in genocide, something that should have been antithetical to the values of their chosen profession. The participation of physicians in torture and murder both before and after World War II is a disturbing legacy seldom discussed in medical school, and underrecognised in contemporary medicine. Is there something inherent in being a physician that promotes a transition from healer to murderer? With this historical background in mind, the author, a medical student, defines and reflects upon moral vulnerabilities still endemic to contemporary medical culture.
http://jme.bmj.com/content/early/2012/05/02/medethics-2011-100372.abstract
Alessandra Colaianni, of Johns Hopkins Medical School, asks the unsettling question: "Is there something inherent in being a physician that promotes a transition from healer to murderer?" Some recent situations in the United States suggest that this is possible: allegations of euthanasia in the wake of Hurricane Katrina, torture of Guantanamo detainees, and the participation of doctors in capital punishment. Colaianni suggests that there are illuminating parallels between medical training and the work of doctors in Auschwitz.
Socialisation and hierarchy: doctors are pressured to conform to group norms, often with techniques like "Sleep deprivation, heightened stress levels and fear of failure". Ambition: just as Nazi doctors participated in the T4 euthanasia program to advance their careers, today's doctors are pressured to succeed even at the risk of losing their integrity. Doctors have a "licence to sin" which can easily be perverted: some "actions are allowed when they are performed by physicians, but are the stuff of horror films and criminal cases when non-licensed personnel attempt them."
Detachment was also a characteristic of Nazi doctors. They could select prisoners by day and dine with their colleagues by night: "the medical profession requires unflappability in the face of things that others would consider disgusting, horrific, or otherwise overwhelming".
Colaianni concludes that medical students need to realise how vulnerable they are to being seduced by the special privileges of their profession. "It is for this reason that a solid grounding in principles of ethics, individualism and human rights is so crucial for physicians and others in positions of power or trust."
http://www.bioedge.org/index.php/bioethics/bioethics_article/10042
http://jme.bmj.com/content/early/2012/05/02/medethics-2011-100372.abstract
Alessandra Colaianni, of Johns Hopkins Medical School, asks the unsettling question: "Is there something inherent in being a physician that promotes a transition from healer to murderer?" Some recent situations in the United States suggest that this is possible: allegations of euthanasia in the wake of Hurricane Katrina, torture of Guantanamo detainees, and the participation of doctors in capital punishment. Colaianni suggests that there are illuminating parallels between medical training and the work of doctors in Auschwitz.
Socialisation and hierarchy: doctors are pressured to conform to group norms, often with techniques like "Sleep deprivation, heightened stress levels and fear of failure". Ambition: just as Nazi doctors participated in the T4 euthanasia program to advance their careers, today's doctors are pressured to succeed even at the risk of losing their integrity. Doctors have a "licence to sin" which can easily be perverted: some "actions are allowed when they are performed by physicians, but are the stuff of horror films and criminal cases when non-licensed personnel attempt them."
Detachment was also a characteristic of Nazi doctors. They could select prisoners by day and dine with their colleagues by night: "the medical profession requires unflappability in the face of things that others would consider disgusting, horrific, or otherwise overwhelming".
Colaianni concludes that medical students need to realise how vulnerable they are to being seduced by the special privileges of their profession. "It is for this reason that a solid grounding in principles of ethics, individualism and human rights is so crucial for physicians and others in positions of power or trust."
http://www.bioedge.org/index.php/bioethics/bioethics_article/10042
Surgeons fail to track PIP implants
The TGA instructed surgeons to contact every patient after they were found more likely to rupture and leak toxins. But three-quarters of the women who have made public submissions to the inquiry said they had to contact their surgeon.
Jodie Blake, a mother of four, said her surgeon even denied using PIP implants, despite issuing her a card stating she had been given the product. ''I wonder how many people they have said this to and who are unknowingly walking around with these ruptured PIP implants in their bodies or, worse still, breastfeeding their little babies with these unknown toxins? This could be disastrous,'' Ms Blake wrote.
A woman with ruptured implants said her surgeon blamed computer problems for not tracking her down. ''I find this a very poor explanation from all involved when my contact details have always been the same and two years have passed since the medical industry were informed of the product recall.''
A woman with ruptured implants said her surgeon blamed computer problems for not tracking her down. ''I find this a very poor explanation from all involved when my contact details have always been the same and two years have passed since the medical industry were informed of the product recall.''
doctors misusing mandatory reporting requirements to undermine the competition
“If doctors make a complaint maliciously, with no real basis, for instance if they’re in competition with another doctor, then that could still leave them open to these sorts of actions”, he said.
MJA InSight has previously reported on doctors misusing mandatory reporting requirements for personal agendas. (4)
http://www.mjainsight.com.au/view?post=defamation-risk-in-reporting-colleagues&post_id=8987&cat=news-and-research
SOME doctors are misusing the new mandatory reporting requirements for their own personal agendas, according to a medical defence organisation and other anecdotal reports.
In a comment article in this week’s MJA InSight, the chief executive officer of Avant, David Nathan, says that a quarter of members’ requests for support on mandatory reporting come from doctors who have been reported to AHPRA. (1)
“Unfortunately, several of these cases involve an undertone of market competition or a personal agenda driving the making of such reports”, Mr Nathan wrote.
Dr Mukesh Haikerwal, chair of the World Medical Association and former president of the AMA, said he was also aware of cases where reports had been made “not in good faith”.
http://www.mjainsight.com.au/view?post=mandatory-reporting-%25e2%2580%259cmisused%25e2%2580%259d&post_id=6941&cat=issue-41-31-october-2011
MJA InSight has previously reported on doctors misusing mandatory reporting requirements for personal agendas. (4)
http://www.mjainsight.com.au/view?post=defamation-risk-in-reporting-colleagues&post_id=8987&cat=news-and-research
SOME doctors are misusing the new mandatory reporting requirements for their own personal agendas, according to a medical defence organisation and other anecdotal reports.
In a comment article in this week’s MJA InSight, the chief executive officer of Avant, David Nathan, says that a quarter of members’ requests for support on mandatory reporting come from doctors who have been reported to AHPRA. (1)
“Unfortunately, several of these cases involve an undertone of market competition or a personal agenda driving the making of such reports”, Mr Nathan wrote.
Dr Mukesh Haikerwal, chair of the World Medical Association and former president of the AMA, said he was also aware of cases where reports had been made “not in good faith”.
http://www.mjainsight.com.au/view?post=mandatory-reporting-%25e2%2580%259cmisused%25e2%2580%259d&post_id=6941&cat=issue-41-31-october-2011
huge percentages of people who give their informed consent to treatment do not really understand what they have chosen
Informed consent is one of the foundations of bioethical discourse. Bureaucrats have forced doctors and researchers to fill out endless forms in the belief that informed consent will enhance patients’ autonomy.
However, questions are being asked about whether this business of informed consent is really working. In an early online article in the Journal of Medical Ethics, Neil Levy, the Australian editor of another journal, Neuroethics, argues that bioethicists need to rethink informed consent.
Why? Because the lesson of all of modern psychology and of post-modern philosophy is that our rationality is terribly flawed. We are blind to the future consequences of our actions; we are not objective in assessing claims that touch us personally; we overestimate the effects of setbacks on our well-being; we are unreliable in estimating how bad or how good events made us feel. In short, human reasoning is subject to many fallibilities. it seems utterly naïve to think that Yes always means Yes and No always means No. So Levy declares that doctors need to return to paternalism, to some extent:
Somewhat surprisingly, Arthur Caplan, of the University of Pennsylvania, probably the best-known bioethicist in the US, agrees with Levy. In a companion article, he says:
http://www.bioedge.org/index.php/bioethics/bioethics_article/9979#comments
However, questions are being asked about whether this business of informed consent is really working. In an early online article in the Journal of Medical Ethics, Neil Levy, the Australian editor of another journal, Neuroethics, argues that bioethicists need to rethink informed consent.
Why? Because the lesson of all of modern psychology and of post-modern philosophy is that our rationality is terribly flawed. We are blind to the future consequences of our actions; we are not objective in assessing claims that touch us personally; we overestimate the effects of setbacks on our well-being; we are unreliable in estimating how bad or how good events made us feel. In short, human reasoning is subject to many fallibilities. it seems utterly naïve to think that Yes always means Yes and No always means No. So Levy declares that doctors need to return to paternalism, to some extent:
“patient autonomy is best promoted by constraining the informed consent procedure. By limiting the degree of freedom patients have to choose, the good that informed consent is supposed to protect can be promoted…
“autonomy is fundamentally inadequate in healthcare settings and requires supplementation by experience-based paternalism on the part of doctors and healthcare providers…
“A large number of studies have shown that huge percentages of people who give their informed consent to treatment or to their involvement in research do not really understand what they have chosen. Autonomy lives with hope and hope, in the form of the therapeutic misconception, often trumps autonomy.”
Questioning informed consent shakes a pillar of modern bioethics and the call for more benevolent paternalism is sure to face stiff opposition.http://www.bioedge.org/index.php/bioethics/bioethics_article/9979#comments
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