Medical Ethics (March/April 1998)



Author: Franklin E. Payne, MD
Article Type: Feature Article
Issue: March/April 1998
Volume Number: 3
Issue Number: 2


The crisis of American medicine is not tobacco, AIDS, silicone implants, the Gulf War Syndrome, breast or other forms of cancer, physician-assisted suicide, euthanasia, licensure, medical care for the poor, or any other specific medical or ethical issue. The crisis of American medicine is far greater than any one of these problems, indeed it is far greater than all of them combined, because the answers to these problems do not come from within them but from medical ethics. It is the same crisis that faces our culture in every other area, how do we decide ethics? That is, how do we decide what is right and what is wrong? Is there a method which will stand the test of time or do ethics change with changing cultures? How are medical-ethical decisions decided today? Few Are Consistent What...




Author: Miguel A. Faria, Jr., MD
Article Type: Feature Article
Issue: March/April 1998
Volume Number: 3
Issue Number: 2


The physician should be contemptuous of money, interested in his work, self-controlled, and just. Once he is possessed of these basic virtues, he will have all others at his command as well. Galen   Can the Medical Profession Survive Flexible Ethics?* The medical writers of antiquity wrote and discussed ethics merely as individuals trying to find out the best way and the right way to conduct themselves using immutable, self-evident principles and propositions in their dual functions as philosophers and medical practitioners. Ethical principles are absolute, and, in a benevolent profession, reflect the authentic feelings of the members of the profession who have answered a calling and are willing to clearly demonstrate what is right and what is wrong, not echo what is politically...




Author: Compiled by Medical Sentinel Editors
Article Type: News and Analysis
Issue: March/April 1998
Volume Number: 3
Issue Number: 2


Kassebaum-Kennedy Law and Immunization Activities An AAPS member has brought to our attention the fact that a portion of the Kassebaum-Kennedy law included in the administrative simplification provisions contained several sections having to do with immunization registries. The information was contained in Immunization News, a newsletter by the Pennsylvania Forum for Primary Health Care (PFPHC; Vol. 2, Issue 2, Summer 1997). The newsletter list the following sections: (1) Standards for electronic health information transactions. This section authorizes the Secretary of HHS to "adopt standards for electronic health information transactions...Providers and health plans will be required to use the standard 24 months after adoption." This provision is thought by PFPHC to be important because...




Author: Miguel A. Faria, Jr., MD
Article Type: Editor's Corner
Issue: March/April 1998
Volume Number: 3
Issue Number: 2


No wonder physicians are demoralized, leaving the profession early, and joining labor unions. They are being enslaved by managed care masters and HMOs, while the concept of managed competition is destroying the medical profession. Yet, it's the American public, all of us as ultimate patients, who have the most to lose. The concept of managed competition embodied in managed care and HMOs, like managed trade in international commerce, is an interventionist (collectivist) concept, a form of industrial policy for medical care, imposed on an old and venerable profession, which, despite the vicissitudes of time, have subscribed to the Oath and medical ethics of Hippocrates since the 5th Century B.C. The ethics of managed care is more akin to Swiss Professor Ernest Truffer's veterinary ethics...




Author: Curtis W. Caine, MD
Article Type: The Constitution - Plain and Simple
Issue: March/April 1998
Volume Number: 3
Issue Number: 2


In Part I of this article, we expounded briefly on the political history of how the Colonies via a successful revolution became States, and how then in the year 1913, via the troika of the Sixteenth Amendment,(1) the establishment of the Federal Reserve System and particularly the Seventeenth Amendment,(2) the Republic was on its way to virtually becoming a democracy.(3) In this issue, we will discuss the events and ramifications of the States forming a Union. Since the several States created the Union, it is axiomatic the Union can not be greater than the States. But, in reality, no longer do we have a central government formed by and subservient to the sovereign States, as was intended, and as was guaranteed by the Senators specifically being designated as the champions of the States....




Author: Samia W. Borchers, MD
Article Type: Report from the States
Issue: March/April 1998
Volume Number: 3
Issue Number: 2


Two years ago, a small group of physicians in Ohio met and formed the Ohio Chapter of the AAPS. Our immediate first priority was to recruit members. Word of mouth brought us additional members. Next, we obtained the names and addresses of approximately 24,000 physicians in Ohio. We sent them test letters in increments of about 5000 each time, introducing ourselves and the AAPS. We changed the letter each time. The last time we informed them of the criminalization in the Kassebaum-Kennedy Bill and sent them a sample letter to send to their representatives. Each of these efforts brought us a small number of members. Most doctors, although they agreed with us, still did not join and we soon realized that besides ideology, we also needed to provide benefits and services in order for our...




Author: John H. Boyles, Jr., MD
Article Type: Correspondence
Issue: March/April 1998
Volume Number: 3
Issue Number: 2


Dear Editor, Congratulations on your Editor’s Corner article in the Fall 1997 issue of the Medical Sentinel. I am rapidly reaching the point of being afraid to criticize my government for fear that I will end up in jail. We recently had an excellent meeting in Columbus, Ohio planned and executed by Nino Camardese, M.D. Leora Traynor, M.D., passed out the enclosed letter [i.e., “FDA and Dr. Shalala Strip Defenseless Patients of Protections of Informed Consent During Experimental Research” in which the FDA has amended informed consent regulations to permit experimental human research, in this case, “a blood derivative” to be given seriously injured patients with severe blood loss and shock in the emergency room of 35 hospitals nationwide]. It appears that the government hasn’t done enough...


FDA


Author: Vernon L. Goltry, MD
Article Type: President's Page
Issue: March/April 1998
Volume Number: 3
Issue Number: 2


Government by man is by virtue of its source of conception inherently evil. What an outrageous statement! And yet, is it really outrageous? Using the Judeo-Christian scriptures as history a remarkable picture emerges which is confirmed throughout history to our present day. According to the Amplified Old Testament (1965) Cain, the first offspring of Adam and Eve, murdered his brother, Abel, and went on to build a city (Genesis 4:17). This, apparently, is the first recorded incident of the creation of an entity (the city) that established a government of man alienated and apart from God. A logical question can be asked. Who put in the mind of Cain, murderer of his brother, the concept of city that expanded into the formation of nations and, therefore, man’s government? Was it God or was it...




Author: P. Gardner Goldsmith
Article Type: Commentary
Issue: March/April 1998
Volume Number: 3
Issue Number: 2


When President and Mrs. Clinton were forced to hang their heads in ignominious defeat after their attempt to federalize the U.S. health care industry was foiled, many believed they had seen the last of such backwards socialist planning. We thought “ClintonCare” was over and done with, a bad memory of a bad idea. Well, it is far from over. The ideological origins of “ClintonCare” have been long standing. And now, with the passage of the 1997 budget bill, it is clear that the Clintons and their political comrades never gave up the fight, they merely employed more subtle tactics. In 1985, Congress passed the Consolidated Omnibus Budget Resolution Act (COBRA). This act, as are most, is a clearly unconstitutional set of proposals that violate a business owner’s right to his property. It...




Author: Jacob Green, MD, PhD
Article Type: Correspondence
Issue: March/April 1998
Volume Number: 3
Issue Number: 2


Dear Editor, Currently, American physicians are reeling from the latest Congressional debacle. $115 billion was taken from Medicare and placed in taxpayers’ pockets as a massive giveaway. Cleverly framed in July 1998 there will be a 40 percent reduction in all Medicare fees. The knee-jerk response is that we will no longer take Medicare. However, what the big picture notes is that many physicians who have entered into managed care agreements note their payment for service is tied directly to the Medicare standards. Congress, in its beneficence, might phase this 40 percent reduction to physicians in over three years rather than doing it in a single draconian slice in July. An as yet unnamed staffer stuck into the latest bill in Congress a provision that any physician who does anything out...




Author: Terree P. Wasley
Article Type: Feature Article
Issue: March/April 1998
Volume Number: 3
Issue Number: 2


Ninety-six year old Elsie Rittman of Tucson, Arizona needed the services of a physician, but was told by the doctor she contacted that he couldn’t afford to take on any more Medicare patients. When she offered to pay him out of her own pocket, she was told it was illegal to spend her own money to see the doctor of her choice. Mrs. Rittman wrote Health and Human Services Secretary Donna Shalala, “I find it hard to believe I can’t spend my money to see the doctor I want. Please write me a letter that tells him that it is legal for me to pay him for the services I want without using my Medicare.” Secretary Shalala responded to Mrs. Rittman that HHS could not give her physician legal permission to accept payment directly from her, and warned that any agreement between her and the doctor would...




Author: Donald J. Palmisano, MD, JD
Article Type: Feature Article
Issue: March/April 1998
Volume Number: 3
Issue Number: 2


The Hippocratic Oath — Is it relevant today or does it belong in the scrap heap of history’s discarded relics? I submit it is relevant today. I submit it is a touchstone that offers a moral compass — an ethical framework — for navigation through these times of crisis. In short, it is the soul of medicine. I submit that the longevity of this Oath is compelling evidence that it is not a frivolous collection of words. Why is it so enduring? I believe it is deemed of value because it offers core values defined specifically, not generally; advice that leaves little room for equivocation or misunderstanding. It does not say in general terms only that a physician should be good or ethical without further explanation of what those terms mean. It is a model of inductive reasoning; it goes from the...




Author: Lawrence R. Huntoon, MD, PhD
Article Type: Correspondence
Issue: March/April 1998
Volume Number: 3
Issue Number: 2


Dear Dr. Faria, I think the story “Managed Care, Medical Ethics, and The Killing of Patients for Profit” couldn’t have come at a more appropriate time [Medical Sentinel 1998;3(1):32-33]. As you know, I wrote this “letter” to Dr. Jane Orient back in January 1997, and since that time we have seen more and more of this information in the lay press. The September edition of the Reader’s Digest, for instance, carried an article entitled “A License to Kill” which details the horrendous situation that exists in the Netherlands. You will note in the Reader’s Digest article they are starting to talk about the concept of a “Duty to Die.” In Holland, physician administrated euthanasia (killing) is the preferred choice over palliative care and hospice services which, as a result, are not widely...




Author: Donald C. Thompson, MD
Article Type: Correspondence
Issue: March/April 1998
Volume Number: 3
Issue Number: 2


Dear Editor, This is an excellent article but the demand for a post-WWII Japanese and Nazi hunt down and execution of the worst of the enemy overlooks the simple fact that we lost the war in Vietnam thanks to our politicians and there has been no true fall of the Soviet Empire just a shift to becoming an economic drain on our economy. The defeated can hardly demand of the victor. Donald C. Thompson, MDFormer Cpt, USAF, MC, FSVietnam veteran and River Rat Originally published in the Medical Sentinel 1998;3(2):37. Copyright © 1998 Association of American Physicians and Surgeons (AAPS).          




Author: Lawrence R. Huntoon, MD, PhD
Article Type: Medical Ethics and Managed Care
Issue: March/April 1998
Volume Number: 3
Issue Number: 2


You know, it’s bad enough doctors have to deal with the complexities and pervasive bungling of the HCFA/Medicare bureaucracy, but what do you tell your patients when they ask you to explain an Explanation Of Medicare Benefits (EOMB)? In an attempt to provide you with the skills you will need to rise to such an occasion, I offer the following true story as a test of your “Blue Bungler IQ.”   Case History Stanley is a pleasant 72-year-old gentleman who came into my office one day with his EOMB in hand, and he wanted us to explain something that appeared on his form. In order to fully appreciate this story, you need to get a visual picture of Stanley. Stanley stands about 6’4”, weighs 280 pounds and suffers from something called “Dunlaps Syndrome.” Dunlaps Syndrome, of course, is an...



It is now legend the AAPS legally lanced the secret task force and pulled its secrets...into the sunshine. It destoyed the Health Security Act.


The Oath of Hippocrates
and the Transformation of Medical Ethics Through Time


Patients within a managed care system have the illusion there exists a doctor-patient relationship...But in reality, it is the managers who decide how medical care will be given.


Judicial activism...the capricious rule of man rather than the just rule of law.


The largest single problem facing American medicine today is the actions of government...


The lessons of history sagaciously reveal wherever governments have sought to control medical care and medical practice...the results have been as perverse as they have been disastrous.


Children are the centerpiece of the family, the treasure (and renewal) of countless civilizations, but they should not be used flagrantly to advance political agendas...


Prejudice against gun ownership by ordinary citizens is pervasive in the public health community, even when they profess objectivity and integrity in their scientific research.


The infusion of tax free money into the MSA of the working poor give this population tax equity with wealthier persons...


It was when Congress started dabbling in constitutionally forbidden activities that deficit spending produced a national debt!


Does the AMA have a secret pact with HCFA?


The lure of socialism is that it tells the people there is nothing they cannot have and that all social evils will be redressed by the state.


Canada's fatal error — Health Care as a Right!


The Cancer Risk from Low Level Radiation: A Review of Recent Evidence...


...Moreover, the gun control researchers failed to consider and underestimated the protective benefits of firearms.


Vandals at the Gates of Medicine — Have They Been Repulsed or Are They Over the Top?