A Day in the Life of a Patient
D. Joy Riley, M.D., M.A. Executive Director
30 November 2022
Her son asked if I could be there by 9:00 A.M., when the hospitalist would likely make rounds. I agreed, and made the three-hour journey on a Monday in November. My friend was the patient, and I, a visitor. What I saw in the ensuing hours made me beyond sad.
A nurse came in to “take her vitals.” That meant she wheeled in a cart with various measuring components: a wristband to measure blood pressure, a probe to take the patient’s temperature, and a pulse oximeter to measure blood oxygen content. The patient was ...read more
Life and Choice
Janet Liljestrand, M.D., M.A.
In 1862 Louis Pasteur performed the definitive experiment that proved even the smallest organisms, those only seen under the microscope, derived from other like organisms. (1) Life came from life. Fast forward to 1973, and Justice Blackmun, writing for the majority decision in Roe v. Wade stated “We need not resolve the difficult decision of when life begins”. (2) What was the Justice’s definition of life? The human zygote contains all it needs for cellular division–and thus growth–at the union of a living sperm and living egg. How then has its human life not begun? Yes, in ...read more
A Tale of Two Data Scientists
Neil Ferguson, Ph.D. Infamous Graph Youyang Gu
D. Joy Riley, M.D., M.A. Executive Director
It was a long year ago (March 2020) that a dire prediction was issued by a group at Imperial College London (UK) regarding the possible effects of the novel coronavirus, SARS-CoV-2. The model predicted more than 500,000 UK deaths, and >2.2 million deaths in the U.S. by summer if no action were taken. One of the data scientists issuing that proclamation was Neil Ferguson, Ph.D. He and his group advised the government that “in the UK and US context, suppression will minimally require a combination of social distancing of the entire ...read more
The Ethics of Rationing COVID-19 Vaccine for the Sickest Among Us
C. Ben Mitchell, Ph.D Distinguished Fellow
We must not allow our combined COVID-19 fatigue to prevent us from asking important questions about public health ethics. At the time I am writing this essay, we are just transitioning into Phase 2 of the vaccination plan. I am sure our public health officials are doing the best they can under unprecedented circumstances, so we should give them the benefit of the doubt. But for the sake of clarity in the future, some retrospective analysis will be crucial.
For instance, in our own state, we have abandoned traditional triage ethics in favor of a purely age-based ...read more
The Problem of Ill-Gotten Gain in Health Care
C. Ben Mitchell, Ph.D. Distinguished Fellow
The politicized debate about President Trump’s treatment for Covid-19 may have shrouded an important set of questions about the science of developing treatments, viz., the problem of ill-gotten gain.
Among other treatment protocols, the President received Regeneron’s REGN-COV2, a “cocktail” of two neutralizing antibodies that has shown promise in some animal studies (see here and here). The media jumped on an association between REGN-COV2 antibodies and fetal cells, some even claiming that the antibodies were developed from fetal cells.
Screenshot of NYT headline on Oct. 8, 2020
The fact of the matter is REGN-COV2 was tested for its virus-neutralizing ...read more
A Project for Our Time
D. Joy Riley, M.D., M.A. Executive Director
The responses to the COVID-19 pandemic have been by turns dramatic and disconcerting, and, at times, draconian. I read about Steve Reiter’s deplorable experience and his new project in a BreakPoint commentary in July, and he was kind enough to speak with me by telephone on 24 July.
Steve’s beloved wife, Elizabeth, had diagnoses of lupus and pulmonary hypertension, among other difficulties. She had had a lengthy hospitalization in 2014, but had recovered. Steve attributes her recovery to excellent medical care and the 24/7 presence of her family. She had a Hickman line placed, and Steve ...read more
When Breath Is (Not Enough) Air: Let’s Talk about Ventilators
There has been much public discussion about ventilators amidst the COVID-19 pandemic. It is humbling to consider that we, or someone we love, might require one. Most people know something about the benefit of a ventilator when needed; but how well do we really understand the functions and risks of mechanical ventilation? The pandemic presents an opportune time to learn about this. So I posed a series of questions about these machines and the processes involved in using them to a physician, who is a specialist in using ventilators to treat very ill patients. Those questions, and her answers, follow.
1) ...read moreCOVID-19 in Wuhan: Plea for Help Retracted
D. Joy Riley, M.D., M.A. Executive Director
One thing is clear: COVID-19, the newest coronavirus to infect humans, has our attention. Locally, people planning to travel—almost anywhere—are wondering about where to obtain face masks. As of Tuesday of this week, reports the New York Times, the United States had 57 cases, with 40 of those related to the Diamond Princess cruise ship that docked in Japan. The NYT article further reported,
“We cannot hermetically seal off the United States to a virus,” Alex M. Azar II, the secretary of health and human services, told a Senate panel on Tuesday. “And we need to ...read moreLife Without Us?
By Jane Patton, Guest Columnist
It is not new that some people say that they do not want to bring children into the world. And, as far as the do’s and don’ts of being environmentally responsible, the carbon footprint of a single human being tops the list of avoidable behaviors. One presidential candidate even advocates abortion as a way to combat climate change. So, it may be okay to have one or two children. Any more than that and parents might be called selfish.
But, a growing movement is taking the idea of limiting births to the next level—preventing all births. Who ...read more