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312 posts categorized "Medicine "

May 31, 2009

Abortion crusader Dr. George Tiller murdered in church

Dr. George Tiller was murdered in church today. Tiller was one of only a handful of physicians in America who perform late-term abortions. He survived an assassination attempt in 1993 and returned to his practice.

Amanda Marcotte has a touching post on George Tiller's life of service:

Dr. Tiller was a brave man and a real hero.  He was already shot once in 1993, but despite the ongoing threat of violence, he continued to work diligently to provide abortion services to women who are often in the worst possible situation, facing down the termination of a pregnancy that was being eagerly planned for, until things went terribly wrong. If a woman has a later term therapeutic abortion---be it because it was a wanted pregnancy, she has serious mental health issues, or she is a child victim of rape---it’s rarely easy on her mentally or physically.  Dr. Tiller’s clinic was renowned for the thoughtful patient support to help women get through what is a very difficult time---counseling, support groups, religious services for the lost baby if you desire.

Dr. Tiller gave his life for women's health and freedom. He must have known that the anti-abortion assasins would strike again. Tiller probably could have saved himself by getting out of the business--a lot of doctors do--but he refused to give in to terrorism.  His legacy will live on.

Update: KWCH-12 is reporting that the police have apprehended a suspected shooter [HT: Jezebel]

May 25, 2009

Norm Costa, Ethics Detective

Unlawful, originally uploaded by It'sGreg.

What happens when a mental health professional becomes a predator? Who suffers? Who is responsible? Is Justice, for perpetrator or victim, something real or abstract? Upon whose shoulders is the burden of justice?

Find out, in the next exciting installment of Norm Costa, Ethics Detective....

April 30, 2009

Making sense of swine flu

Revere cuts through the constantly changing and sometimes conflicting numbers being bandied about to describe the expanding swine flu outbreak.

Instead of fixating on the latest number of cases suspected in region X or confirmed in region Y, he argues, we should focus on the big picture:

What's the take home message? We should stop fixating on hourly changes in numbers or differences about the sequences and keep our eye on the Big Picture. Right now that picture is still cloudy, but will be coming into sharper focus as new information accrues and is organized. Generally, though, we have a novel virus (in the sense that the human population is immunologically naive to it) that is spreading person to person and seems to have clinical characteristics not unlike usual seasonal influenza. Because of its novelty the number of people it could make sick is potentially far greater than a seasonal virus, however, since there is no naturally acquired immunity we know of at the moment (it may turn out there is some cross reactivity with some other strain from years past but so far we have no evidence of that).

As a Big Picture, it's not the most comforting, whatever the day to day numbers.

One reason it's hard to focus on the big picture is the novelty of our bird's eye perspective on the situation. As Revere notes, this is the first time that we've actually watched a flu pandemic unfold in real time.

April 17, 2009

Parents seek fast-tracked public funds for rape-reeducation camp

My friend Maia Szalavitz has an amazing story about an allegedly abusive boarding school in Oregon that has found itself in the middle of a Supreme Court battle over state reimbursement for special needs education.

The Court will decide whether parents get reimbursed for special education before the public special ed program has tried and failed to help their kid. It just so happens that the parents who are suing want to send their son to a self-proclaimed therapeutic boarding school that uses bizarre and abusive methods to "treat" kids for a variety of ills ranging from post-rape trauma to ADHD and marijuana use.

The case isn't about the merits of the curriculum, but it has focused national attention on abuse allegations against the Mount Bachelor Academy. Szalavitz interviewed several former Mount Bachelor residents who told consistent stories of sexualized abuse and humiliation in the name of treatment.

Some of the female inmates were sent to the school specifically to treat behavioral problems supposedly linked to rape:

But according to 10 students, two separate parents, and a current part-time employee interviewed by TIME — some of whom are involved in the state inquiry — Mount Bachelor Academy regularly uses intensely humiliating tactics as treatment. For instance, in required seminars that the school calls Lifesteps, students say staff members of the residential program have instructed girls, some of whom say they have been victims of rape or sexual abuse in the past, to dress in provocative clothing — fishnet stockings, high heels and miniskirts — and perform lap dances for male students, as therapy.


One 18-year-old former student and victim of rape wept while recounting what happened to her during a Lifestep seminar. Jane, who asked not to be identified with her real name, left the school in March. "They had me dress up as a French maid," she said, describing an outfit that included fishnet stockings and a short skirt. "I had to sit on guys' laps and give them lap dances," while sexually suggestive songs, such as "Milkshake" by Kelis, played at high volume.

"They told me I was dirty and I had to put mud on myself for being raped," she said, in reference to a separate Lifestep session. "They basically blamed me for getting raped." [TIME]

Mount Bachelor promises to cure "promiscuity" and drug use in rape survivors.

Former resident Amber Ozier told Szalavitz that the school forced her to role-play the drowning death of her younger sister in the name of therapy. Mount Bachelor's interventions is designed to stress and humiliate students until they regress to a hyper-suggestible infantile state for easy reprogramming.

One of the heroes of this story is whistle-blower Susan Owren, a part-time driver for the school who reported the school to the state in mid-March after hearing dozens of similar stories of abuse from students. "Every single kid has told me something horrifying," she told TIME.

Owren's complaint sparked an official investigation that is ongoing.

March 24, 2009

New York does little to stop illegal female genital mutilation

Female genital mutilation is illegal in New York State, but as Alyson Zureick reports in the latest issue of the Gotham Gazette, authorities are neither prosecuting offenders nor performing legally-mandated education and outreach to communities that have historicially practiced FGM.

According to one estimate, 41,000 women in New York are at risk of being cut, or have already been subjected to genital cutting. This estimate is based on data from the 2000 census, so clearly more up-to-date information is needed.

Female genital cutting can range in severity from a harmless ritual pinprick to the complete surgical removal of the external genitals. These procedures can cause acute and chronic infections, loss of sexual sensitivity, difficult labor, and PTSD.

According to a lawyer quoted in the article, no one has ever been charged under New York's anti-FGM statute or its federal equivalent since the laws were enacted in the mid-nineties. The last state-level FGM outreach program in New York took place a decade ago.

A handful of community-based organizations, including the Sauti Yetu Center for African Women, are grappling with the problem at the grassroots level. State officials are currently engaged in discussions with these groups about how best to address FGM.

In early 2009, Assemblywoman Barbara Clark of Queens reintroduced legislation that would require State health authorities to present an annual report to the legislature documenting their efforts to combat FGM. The bill is currently before the Senate health subcommittee.

March 18, 2009

Weekly Pulse: Sex, drugs, and the single payer

This week's highlights in healthcare reporting from the Media Consortium.

March 11, 2009

The Jayson Blair of biomedical research, exposed

A leading proponent of non-narcotic analgesics has confessed to fabricating 21 journal articles since 1996:

In what may be among the longest-running and widest-ranging cases of academic fraud, one of the most prolific researchers in anesthesiology has admitted that he fabricated much of the data underlying his research, said a spokeswoman for the hospital where he works.

The researcher, Dr. Scott S. Reuben, an anesthesiologist in Springfield, Mass., who practiced at Baystate Medical Center, never conducted the clinical trials that he wrote about in 21 journal articles dating from at least 1996, said Jane Albert, a spokeswoman for Baystate Health.

The reliability of dozens more articles he wrote is uncertain, and the common practice — supported by his studies — of giving patients aspirinlike drugs and neuropathic pain medicines after surgery instead of narcotics is now being questioned. [NYT]

Between 2002 and 2007, Dr. Reuben's research was underwritten by the pharmaceutical giant Pfizer, according to the story.

February 28, 2009

Sen. Harkin: National Center for Alternative Medicine disproves too much alternative medicine

Careful what you wish for...

Sen. Tom Harkin, the proud father of the National Center for Complimentary and Alternative Medicine, told a Senate hearing on Thursday that NCCAM had disappointed him by disproving too many alternative therapies.

"One of the purposes of this center was to investigate and validate alternative approaches. Quite frankly, I must say publicly that it has fallen short," Harkin said.

The senator went on to lament that, since its inception in 1998, the focus of NCCAM has been "disproving things rather than seeking out and approving things."

Skeptics have complained all along that Harkin and his allies founded this office to promote alternative therapies at public expense, not to test them scientifically. Harkin's statement at the hearing explicitly confirms that hypothesis.

Harkin used his clout on the Appropriations Committee in 1992 to create the National Office of Alternative Medicine. In 1998 he co-sponsored legislation with Republican Bill Frist to upgrade the national office to a national center.

Over a decade later, Harkin's disappointed that the NCCAM's research is failing to confirm his biases.

Harkin doesn't seem to realize that by publicly pressuring an ostensibly independent research center to produce positive results, he's undermining the credibility of the center he worked so hard to create. If even if NCCAM does come up with positive results, Harkin's giving the scientific community an excuse to discount that research as tainted.

That's a shame, because if we're going to spend public money testing alternative medicines, researchers should be allowed to follow the evidence. Besides, ruling out therapies that don't work can be just as valuable as vindicating therapies that do.

A lot of modern medicine has roots in folk traditions. No doubt there are more therapies currently labeled as "alternative" that will eventually earn their rightful places in scientific medicine and the allied health professions when they are proven effective.

Video of Thursday's hearing on "integrative medicine" is available on the Senate Health Education Labor and Pensions Committee website, here. Harkin starts talking about NCCAM's annoying habit of disproving cherished tenets of alternative medicine about 17 minutes into the hearing.

February 26, 2009

Weight-loss study re-confirms laws of thermodynamics

A new study shows that cutting calories, any kind of calories, leads to weight-loss:

That is the finding of the largest-ever controlled study of weight-loss methods published on Wednesday in The New England Journal of Medicine. More than 800 overweight adults in Boston and Baton Rouge, La., were assigned to one of four diets that reduced calories through different combinations of fat, carbohydrates and protein. Each plan cut about 750 calories from a participant’s normal diet, but no one ate fewer than 1,200 calories a day.

While the diets were not named, the eating plans were all loosely based on the principles of popular diets like Atkins, which emphasizes low carbohydrates; Dean Ornish, which is low-fat; or the Mediterranean diet, with less animal protein. All participants also received group or individual counseling. [NYT]

On average, all the groups lost (13 lbs) and subsequently regained (4 lbs) the same amount of weight.

The researchers also found a great deal of variability in between individual dieters assigned to the same programs. Next on their research agenda: Trying to understand why some people lost a lot more weight than others on the same diet.

Defenders of fad diets will seize on these individual differences as evidence that diets have to be tailored to individual "metabolic" differences. Cue the woo.

It's possible that diet itself wasn't responsible for the different amounts of weight loss. Maybe the subjects who lost the most weight were just the most conscientious dieters (or "cheaters" who ate less than the researchers told them) or the people with the fastest metabolisms. It's also possible that individual food preferences influenced compliance.

We won't know without further research.

[HT: Jezebel.]

February 25, 2009

Weekly Pulse: Czar 44, Where are You?

The Obama administration may be about to pull the plug on the newly-created office of health czar. What are the potential implications for healthcare reform? Find out, in the latest edition of The Media Consortium's Weekly Howard Dean on comparative effectiveness research, a new spray-on contraceptive, and much more.