Wednesday, December 18, 2019

A day in the hospital in the USA


James Medlock (@jdcmedlock)
Average out-of-pocket spending for a day in the hospital

US: $1,013

Austria: $22
Germany: $11
Sweden: $11
Estonia: $2
Norway: Free
Denmark: Free
Canada: Free
Italy: Free
United Kingdom: Free
Portugal: Free
Spain: Free
Israel: Free
Iceland: Free
Poland: Free

Wednesday, December 11, 2019

Terminally Ill at 25 and Fighting Fake News on Vaccines

In 2015, an anti-vaccination campaign in Ireland caused a sudden fall in the uptake of the HPV vaccine. Then Laura Brennan got involved.
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Terminally Ill at 25 and Fighting Fake News on Vaccines

We’ll need more than facts to fight medical misinformation

You all know about how fake news is threatening your democracy. But there’s another type of misinformation that’s threatening our very health. And this time, people are dying. I’m talking about medical misinformation. Roughly 49 percent of Americans believe in at least one medical conspiracy theory. When people are diagnosed, with cancer and they go online, they’re often hit with absolute falsehoods. These scare patients. And they either delay their conventional treatment or they sometimes reject it. My name is Dr. David Robert Grimes. I’m a cancer researcher. And when a vaccination confidence crisis came to Ireland, my home country, I found myself on the front line. Let me tell you about the human papilloma virus or H.P.V. Every year about 270,000 women die of cervical cancer caused by H.P.V. infection. But for the first time in our history, we now have a vaccine that prevents against it. It’s difficult to overstate how effective this vaccine has been. In America, H.P.V. infection in young girls has dropped about 88 percent. But then things changed. In Japan in 2013, sustained anti-vaccine activism led to a panic, which saw vaccination rates for H.P.V. dropped from 70 percent to less than 1 percent within a year or two. In 2014, a similar outbreak of panic came to Denmark. In the U.S.A., H.P.V. vaccination rates in adolescence remain critically low, hovering at around 16 percent. “The uptake rate for the H.P.V. vaccine has dropped.” In 2015, panic about the H.P.V. vaccine came to Ireland. “For some girls and young women, the side effects of Gardasil go well beyond a few months.” I couldn’t believe that I was hearing, such dangerous falsehoods about a vaccine that prevents 5 percent of all cancers. “We only ever wanted what was best for our girls.” Within a year or so, Irish vaccination rates had gone from highs of 87 percent to about 50 percent. It starts with this: As rational as we like to think we are, and as logical, the truth is that we emote first and we reason later. “And I watched my baby go boom and hit the ground.” You’ll often see a scare story that says — particularly a teenage girl — has had an adverse effect to this vaccination. “I believe with all my heart that the Gardasil vaccination did this to her.” And it’ll be delivered in a very frightening way that captures your attention. “I was such an intelligent girl and now I’ve just got this fog over my mind.” It doesn’t matter that the stories lack any veracity. What matters is they scare us and in scaring us we remember them. And in remembering them, we afford them more weight than they deserve. And so starts a vicious cycle. This explains why lies about the H.P.V. vaccine were able to do so much damage in so many countries. But in Ireland, what really changed the situation was a woman called Laura Brennan. When Laura was 24, she was diagnosed with cervical cancer, and by the time she was 25, that was metastatic noncurable. Laura was alarmed that people weren‘t getting this vaccine that could prevent women from being in the situation that she found herself in. Her campaigning started with a series of advertisements where she talked to parents directly to them. “Protect our future.” She was on talk shows. She was interviewed in magazines. “If anything good comes out of this, I would hope parents would get their daughters vaccinated. The vaccine saves lives. It could have saved mine.” She said, I am the reality of an unvaccinated girl. “So it just shows you how fast and aggressive my cancer is. But yeah, that’s life.” It’s no good just throwing facts of people until you can show them why those facts matter. In Ireland, thanks in large part to her campaigning, rates climbed back up over 70 percent, and are continuing to climb. It shows that you can reverse some of this damage. “When I found out that my cancer was terminal, I wanted to use my voice for good, and for the last 12 months, I haven’t shut up.” Laura exemplified something really, really important: That you never change minds without changing hearts as well. All the journal articles in the world, all the physicians and scientists in the world, saying something is for nothing if you can’t reach people on a visceral emotional level and show them why something matters. I was incredibly honored and privileged to be close to Laura Brennan. She passed away on the 20th of March 2019, aged only 26. But she leaves behind a legacy that will extend far beyond most of our lifetimes. And she will save more lives than a library of journal articles and scientific experts in isolation could ever hope to achieve. And that’s some legacy to leave behind.
5:09Terminally Ill at 25 and Fighting Fake News on Vaccines
We’ll need more than facts to fight medical misinformationCreditCredit...RTÉ Television
By David Robert Grimes
Dec. 11, 2019

Video by Adam Westbrook

In 2019, measles cases in the U.S. have been on the rise, much of it driven by false claims about the safety of the vaccine.

In the Video Op-Ed above, a cancer researcher, David Robert Grimes, confronts the rising trend of medical misinformation. From herbal remedies for cancer to vaccination horror stories, fake medical news is spreading fast on social media.

The effects can be severe, with anti-vaccination movements partly responsible for the resurgence of measles and other preventable illnesses.

In 2015, an anti-vaccination campaign in Ireland caused a sudden fall in the number of HPV vaccines administered, given to young girls and boys to prevent cervical cancer. Dr. Grimes tells the story of how, with the help of a remarkable woman named Laura Brennan, they were able to reverse the trend, and what countries like the United States can learn in their fight against medical misinformation.

David Robert Grimes (@drg1985), a cancer researcher and physicist, is author of “The Irrational Ape: Why Flawed Logic Puts Us All at Risk and How Critical Thinking Can Save the World.”

Tuesday, December 10, 2019

The difference between ethics and morality

Ethics is a more inclusive matter than morality; it concerns character whereas morality concerns actions. Our actions will mainly of course flow from our character, but the targets of enquiry in ethics (seeking answers to What sort of person shall I be?) and in debates about morality (What is the right thing to do in this case?) are obviously not the same... A.C. Grayling, The History of Philosophy


Monday, December 9, 2019

Notable books

Among the 100 Notable Books of 2019 (as selected by the NYTimes)...

By KATHERINE EBAN.
$28.99. Ecco/HarperCollins.
Nonfiction.
In her stunning exposé, Eban describes an industry rife with corruption and life-threatening misdeeds exacerbated by lax regulation...
By DANIEL OKRENT. $32.00. Scribner.
Nonfiction.
In 1920s America, a mix of nativist sentiment and pseudoscience led to the first major law curtailing immigration. Okrent focuses on eugenics, which argued that letting in people of certain nationalities and races would harm America’s gene pool...
By JULIE YIP-WILLIAMS. $27.00. Random House.
Nonfiction. Memoir.
Written before her death last year from cancer at the age of 42, Yip-Williams’s book is a remarkable woman’s moving exhortation to the living.
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‘THE UNDYING: Pain, Vulnerability, Mortality, Medicine, Art, Time, Dreams, Data, Exhaustion, Cancer, and Care’ By Anne Boyer (Farrar, Straus & Giroux). Boyer’s extraordinary and furious book is partly a memoir of her illness, diagnosed five years ago; she was 41 when she learned that the lump in her breast was triple-negative cancer, one of the deadliest kinds. But her story, told with searing specificity, is just one narrative thread in a book that reflects on the possibility — or necessity — of finding common cause in individual suffering.

Sunday, December 8, 2019

George Church


60 Minutes (@60Minutes)
“So you went from George’s skin cells, turned those into stem cells, and turned those into brain cells?”

60 Minutes reports on the wild possibilities brought by genetic engineering, tonight.

cbsn.ws/34XvxJf

The weird world of medical billing.

Where the Frauds Are All Legal

Much of what we accept as legal in medical billing would be regarded as fraud in any other sector.

I have been circling around this conclusion for this past five years, as I’ve listened to patients’ stories while covering health care as a journalist and author. Now, after a summer of firsthand experience — my husband was in a bike crash in July — it’s time to call out this fact head-on. Many of the Democratic candidates are talking about practical fixes for our high-priced health care system, and some legislated or regulated solutions to the maddening world of medical billing would be welcome.

My husband, Andrej, flew over his bicycle’s handlebars when he hit a pothole at high speed on a Sunday ride in Washington. He was unconscious and lying on the pavement when I caught up with him minutes later. The result: six broken ribs, a collapsed lung, a broken finger, a broken collarbone and a broken shoulder blade.

The treatment he got via paramedics and in the emergency room and intensive care unit were great. The troubles began, as I knew they would, when the bills started arriving.

I will not even complain here about some of the crazy high charges: $182 for a basic blood test, $9,289 for two days in a room in intensive care, $20 for a pill that costs pennies at a pharmacy. We have great insurance, which negotiates these rates down. And at least Andrej got and benefited from those services... (continues)

Saturday, December 7, 2019

Can Biology Class Reduce Racism?

COLORADO SPRINGS — Biology textbooks used in American high schools do not go near the sensitive question of whether genetics can explain why African-Americans are overrepresented as football players and why a disproportionate number of American scientists are white or Asian.

But in a study starting this month, a group of biology teachers from across the country will address it head-on. They are testing the idea that the science classroom may be the best place to provide a buffer against the unfounded genetic rationales for human difference that often become the basis for racial intolerance.

At a recent training in Colorado, the dozen teachers who had volunteered to participate in the experiment acknowledged the challenges of inserting the combustible topic of race and ancestry into straightforward lessons on the 19th-century pea-breeding experiments of Gregor Mendel and the basic function of the strands of DNA coiled in every cell.

The new approach represents a major deviation from the usual school genetics fare, which devotes little time to the extent of genetic differences across human populations, or how traits in every species are shaped by a complex mix of genes and environment.

It also challenges a prevailing belief among science educators that questions about race are best left to their counterparts in social studies.

The history of today’s racial categories arose long before the field of genetics and have been used to justify all manner of discriminatory policies. Race, a social concept bound up in culture and family, is not a topic of study in modern human population genetics, which typically uses concepts like “ancestry” or “population” to describe geographic genetic groupings.

But that has not stopped many Americans from believing that genes cause racial groups to have distinct skills, traits and abilities. And among some biology teachers, there has been a growing sense that avoiding any direct mention of race in their genetics curriculum may be backfiring.

“I know it’s threatening,” said Brian Donovan, a science education researcher at the nonprofit BSCS Science Learning who is leading the study. “The thing to remember is that kids are already making sense of race and biology, but with no guidance.”

Human population geneticists have long emphasized that racial disparities found in society do not in themselves indicate corresponding genetic differences. A recent paper by leading researchers in the field invokes statistical models to argue that health disparities between black and white Americans are more readily explained by environmental effects such as racism than the DNA they inherited from ancestors... (continues)

Monday, December 2, 2019

Bioethics, Spring 2020

Returning to MTSU, January 2020-

PHIL 3345,
Dr. Phil Oliver-Office hours TTh 11:15-12:45 & by appt.
TTh 4:20-5:45 pm, Peck Hall 305
Supporting the philosophical study of bioethics, biomedical ethics, biotechnology, and the future of life, at Middle Tennessee State University and beyond... "Keep your health, your splendid health. It is better than all the truths under the firmament." William James
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Our anchoring theme: the psychological and social dimensions of medicine and the life sciences from birth to death, with a special emphasis this semester on the “biopolitics” of new and emerging biotechnologies such as assisted reproduction, human genetic modification, and DNA forensics.”

Texts 2020 We’ll begin with these texts:

  • Bioethics: The Basics (Campbell) ”...the word ‘bioethics’ just means the ethics of life…” 
  • Beyond Bioethics (Obasogie) “Bioethics’ traditional emphasis on individual interests such as doctor-patient relationships, informed consent, and personal autonomy is minimally helpful in confronting the social and political challenges posed by new human biotechnologies…” 
Each student will also choose and report on an additional relevant text, thus enabling us to extend our study of the field by “crowd-sourcing” many more of the crucial issues it raises.

For more info contact phil.oliver@mtsu.edu, or visit http://bioethjpo.blogspot.com/