Good Ethics and Bad Choices

Good Ethics and Bad Choices

Author: Jennifer S. Blumenthal-Barby

Publisher: MIT Press

Published: 2021-08-03

Total Pages: 265

ISBN-13: 0262365308

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An analysis of how findings in behavioral economics challenge fundamental assumptions of medical ethics, integrating the latest research in both fields. Bioethicists have long argued for rational persuasion to help patients with medical decisions. But the findings of behavioral economics—popularized in Thaler and Sunstein’s Nudge and other books—show that arguments depending on rational thinking are unlikely to be successful and even that the idea of purely rational persuasion may be a fiction. In Good Ethics and Bad Choices, Jennifer Blumenthal-Barby examines how behavioral economics challenges some of the most fundamental tenets of medical ethics. She not only integrates the latest research from both fields but also provides examples of how physicians apply concepts of behavioral economics in practice. Blumenthal-Barby analyzes ethical issues raised by “nudging” patient decision making and argues that the practice can improve patient decisions, prevent harm, and perhaps enhance autonomy. She then offers a more detailed ethical analysis of further questions that arise, including whether nudging amounts to manipulation, to what extent and at what point these techniques should be used, when and how their use would be wrong, and whether transparency about their use is required. She provides a snapshot of nudging “in the weeds,” reporting on practices she observed in clinical settings including psychiatry, pediatric critical care, and oncology. Warning that there is no “single, simple account of the ethics of nudging,” Blumenthal-Barby offers a qualified defense, arguing that a nudge can be justified in part by the extent to which it makes patients better off.


Good Medicine, Bad Behavior

Good Medicine, Bad Behavior

Author:

Publisher:

Published: 2009

Total Pages: 44

ISBN-13:

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Guide includes tips for parents and teachers, online resources and a glossary of drug related terms and slang terms for various prescription drugs.


Medications for Opioid Use Disorder Save Lives

Medications for Opioid Use Disorder Save Lives

Author: National Academies of Sciences, Engineering, and Medicine

Publisher: National Academies Press

Published: 2019-06-16

Total Pages: 175

ISBN-13: 0309486483

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The opioid crisis in the United States has come about because of excessive use of these drugs for both legal and illicit purposes and unprecedented levels of consequent opioid use disorder (OUD). More than 2 million people in the United States are estimated to have OUD, which is caused by prolonged use of prescription opioids, heroin, or other illicit opioids. OUD is a life-threatening condition associated with a 20-fold greater risk of early death due to overdose, infectious diseases, trauma, and suicide. Mortality related to OUD continues to escalate as this public health crisis gathers momentum across the country, with opioid overdoses killing more than 47,000 people in 2017 in the United States. Efforts to date have made no real headway in stemming this crisis, in large part because tools that already existâ€"like evidence-based medicationsâ€"are not being deployed to maximum impact. To support the dissemination of accurate patient-focused information about treatments for addiction, and to help provide scientific solutions to the current opioid crisis, this report studies the evidence base on medication assisted treatment (MAT) for OUD. It examines available evidence on the range of parameters and circumstances in which MAT can be effectively delivered and identifies additional research needed.


Pain Management and the Opioid Epidemic

Pain Management and the Opioid Epidemic

Author: National Academies of Sciences, Engineering, and Medicine

Publisher: National Academies Press

Published: 2017-09-28

Total Pages: 483

ISBN-13: 0309459575

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Drug overdose, driven largely by overdose related to the use of opioids, is now the leading cause of unintentional injury death in the United States. The ongoing opioid crisis lies at the intersection of two public health challenges: reducing the burden of suffering from pain and containing the rising toll of the harms that can arise from the use of opioid medications. Chronic pain and opioid use disorder both represent complex human conditions affecting millions of Americans and causing untold disability and loss of function. In the context of the growing opioid problem, the U.S. Food and Drug Administration (FDA) launched an Opioids Action Plan in early 2016. As part of this plan, the FDA asked the National Academies of Sciences, Engineering, and Medicine to convene a committee to update the state of the science on pain research, care, and education and to identify actions the FDA and others can take to respond to the opioid epidemic, with a particular focus on informing FDA's development of a formal method for incorporating individual and societal considerations into its risk-benefit framework for opioid approval and monitoring.


Ending Discrimination Against People with Mental and Substance Use Disorders

Ending Discrimination Against People with Mental and Substance Use Disorders

Author: National Academies of Sciences, Engineering, and Medicine

Publisher: National Academies Press

Published: 2016-09-03

Total Pages: 171

ISBN-13: 0309439124

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Estimates indicate that as many as 1 in 4 Americans will experience a mental health problem or will misuse alcohol or drugs in their lifetimes. These disorders are among the most highly stigmatized health conditions in the United States, and they remain barriers to full participation in society in areas as basic as education, housing, and employment. Improving the lives of people with mental health and substance abuse disorders has been a priority in the United States for more than 50 years. The Community Mental Health Act of 1963 is considered a major turning point in America's efforts to improve behavioral healthcare. It ushered in an era of optimism and hope and laid the groundwork for the consumer movement and new models of recovery. The consumer movement gave voice to people with mental and substance use disorders and brought their perspectives and experience into national discussions about mental health. However over the same 50-year period, positive change in American public attitudes and beliefs about mental and substance use disorders has lagged behind these advances. Stigma is a complex social phenomenon based on a relationship between an attribute and a stereotype that assigns undesirable labels, qualities, and behaviors to a person with that attribute. Labeled individuals are then socially devalued, which leads to inequality and discrimination. This report contributes to national efforts to understand and change attitudes, beliefs and behaviors that can lead to stigma and discrimination. Changing stigma in a lasting way will require coordinated efforts, which are based on the best possible evidence, supported at the national level with multiyear funding, and planned and implemented by an effective coalition of representative stakeholders. Ending Discrimination Against People with Mental and Substance Use Disorders: The Evidence for Stigma Change explores stigma and discrimination faced by individuals with mental or substance use disorders and recommends effective strategies for reducing stigma and encouraging people to seek treatment and other supportive services. It offers a set of conclusions and recommendations about successful stigma change strategies and the research needed to inform and evaluate these efforts in the United States.


Facing Addiction in America

Facing Addiction in America

Author: Office of the Surgeon General

Publisher: Createspace Independent Publishing Platform

Published: 2017-08-15

Total Pages: 420

ISBN-13: 9781974580620

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All across the United States, individuals, families, communities, and health care systems are struggling to cope with substance use, misuse, and substance use disorders. Substance misuse and substance use disorders have devastating effects, disrupt the future plans of too many young people, and all too often, end lives prematurely and tragically. Substance misuse is a major public health challenge and a priority for our nation to address. The effects of substance use are cumulative and costly for our society, placing burdens on workplaces, the health care system, families, states, and communities. The Report discusses opportunities to bring substance use disorder treatment and mainstream health care systems into alignment so that they can address a person's overall health, rather than a substance misuse or a physical health condition alone or in isolation. It also provides suggestions and recommendations for action that everyone-individuals, families, community leaders, law enforcement, health care professionals, policymakers, and researchers-can take to prevent substance misuse and reduce its consequences.


Hospital

Hospital

Author: Julie Salamon

Publisher: Penguin

Published: 2008

Total Pages: 392

ISBN-13: 9781594201714

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A bestselling author and award winning journalist follows a year in the life of a big urban hospital, painting a revealing portrait of how medical care is delivered in America today Most people agree that there are complicated issues at play in the delivery of health care today, but those issues may not always be what we think they are. In 2005, Maimonides Hospital in Brooklyn, New York, unveiled a new state-of-theart, multimillion-dollar cancer center. Determined to understand the whole spectrum of factors that determine what kind of medical care people receive in this country, bestselling author Julie Salamon spent one year tracking the progress of the center and getting to know the characters who make the hospital run. Located in a community where sixty-seven different languages are spoken, Maimonides is a case study for the particular kinds of concerns that arise in institutions that serve an increasingly multicultural American demographic. Granted an astonishing “warts and all” level of access by the hospital higher-ups, Salamon followed the doctors, patients, administrators, nurses, ambulance drivers, cooks, and cleaning staff. She explored not just the action on the ground—what happens between doctors and patients—but also the financial, ethical, technological, sociological, and cultural matters that the hospital community encounters every day. Drawing on her skills as interviewer, observer, and social critic, Salamon presents the story of modern medicine, uniquely viewed from the vantage point of those who make it run. She draws out the internal and external political machinations that exist between doctors and staff as well as between hospital and community. And she grounds the science and emotion of medical drama in the financial realities of operating a huge, private institution that must contend with issues like adapting to the specific needs of immigrant groups that make up a large and growing portion of our society. Salamon exposes struggles of both the profound and humdrum variety. There are bitter internal feuds, warm personal connections, comedy, egoism, greed, love, and loss. There are rabbinic edicts to contend with as well as imams and herbalists and local politicians. There are system foul-ups that keep blood test results from being delivered on time, careless record keepers, shortages of everything except forms to fill, recalcitrant and greedy insurance reimbursement systems, and the surprising difficulty of getting doctors to wash their hands. This is the dynamic universe of small and large concerns and personalities that, taken together, determine the nature of our care and assume the utmost importance. As Martin Payson—chairman of the board at Maimonides and ex-Time-Warner vice chairman—puts it: “Hospitals have a lot in common with the movie business. You’ve got your talent, entrepreneurs, ambition, ego stroking, the business versus the creative part. The big difference is that in the hospital you don’t get second takes. Movies are make-believe. This is real life.”


Behavioral Medicine A Guide for Clinical Practice 5th Edition

Behavioral Medicine A Guide for Clinical Practice 5th Edition

Author: Mitchell D. Feldman

Publisher: McGraw Hill Professional

Published: 2019-12-06

Total Pages: 641

ISBN-13: 1260142698

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The #1 guide to behavioral issues in medicine delivering thorough, practical discussion of the full scope of the physician-patient relationship "This is an extraordinarily thorough, useful book. It manages to summarize numerous topics, many of which are not a part of a traditional medical curriculum, in concise, relevant chapters."--Doody's Review Service - 5 stars, reviewing an earlier edition The goal of Behavioral Medicine is to help practitioners and students understand the interplay between psychological, physical, social and cultural issues of patients. Within its pages readers will find real-world coverage of behavioral and interactional issues that occur between provider and patient in everyday clinical practice. Readers will learn how to deliver bad news, how to conduct an effective patient interview, how to care for patients at the end of life, how to clinically manage common mental and behavioral issues in medical patients, the principles of medical professionalism, motivating behavior change, and much more. As the leading text on the subject, this trusted classic delivers the most definitive, practical overview of the behavioral, clinical, and social contexts of the physician-patient relationship. The book is case based to reinforce learning through real-world examples, focusing on issues that commonly arise in everyday medical practice and training. One of the significant elements of Behavioral Medicine is the recognition that the wellbeing of physicians and other health professionals is critically important to caring for patients.


Good Reasons for Bad Feelings

Good Reasons for Bad Feelings

Author: Randolph M. Nesse, MD

Publisher: Penguin

Published: 2019-02-12

Total Pages: 386

ISBN-13: 1101985682

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A founder of the field of evolutionary medicine uses his decades of experience as a psychiatrist to provide a much-needed new framework for making sense of mental illness. Why do I feel bad? There is real power in understanding our bad feelings. With his classic Why We Get Sick, Dr. Randolph Nesse helped to establish the field of evolutionary medicine. Now he returns with a book that transforms our understanding of mental disorders by exploring a fundamentally new question. Instead of asking why certain people suffer from mental illness, Nesse asks why natural selection has left us all with fragile minds. Drawing on revealing stories from his own clinical practice and insights from evolutionary biology, Nesse shows how negative emotions are useful in certain situations, yet can become overwhelming. Anxiety protects us from harm in the face of danger, but false alarms are inevitable. Low moods prevent us from wasting effort in pursuit of unreachable goals, but they often escalate into pathological depression. Other mental disorders, such as addiction and anorexia, result from the mismatch between modern environment and our ancient human past. And there are good evolutionary reasons for sexual disorders and for why genes for schizophrenia persist. Taken together, these and many more insights help to explain the pervasiveness of human suffering, and show us new paths for relieving it by understanding individuals as individuals.