What You Can Do to Make Healthcare Safer
Posted by drbob2 on Jun 23, 2009
What You Can Do to Make Healthcare Safer
On the broadcast/webcast this morning I made a point of exploring in some detail a one page
Consumer Fact Sheet published by the National Patient Safety Foundation.
That document is available at: What You Can Do.
As you see when you access that link, there are 5 categories of actions to take to do what you and I, as patients, can to protect ourselves from medical errors.
1. Become a more informed health care consumer.
There’s a wealth of information available in seconds on the internet about all sorts of illnesses and conditions but you have to use your common sense in interpreting it. What you find may either scare you witless or minimize the realities of your specific problem. Perhaps the best use of information you find is to generate questions to ask your family doctor or the specialist, if that is the most appropriate person. If the answers you receive don’t make sense to you, remember that you always have a right to a second opinion and you should not be shy about obtaining one, either on your doctor’s referral or one you obtain by yourself. If you do seek a second opinion, be sure to ask the doctor providing it to obtain your medical history and all test results from your first doctor.
2. Keep track of your history.
Many patients assume that your doctor has an up to the minute record of everything you have told him or her and all the test results and medicines that you are taking and why you are taking them. While that may be the case, especially if your doctor cares for you within the concept of a Medical Home, don’t count on it—we’re talking about your health now. Take the time to write down, either on paper or on a computer document—which I strongly recommend—all the aspects of your health over the years: Illnesses, hospitalizations, operations, (with the years, if possible) current medications (and past meds, if relevant), any family history of disease and any allergies, bleeding tendencies, cortisone use, diabetes, or blood clots (in legs or lungs) in your past. Also include any tests that were done and their results (remember, you have a right to all medical test results so ask your doctor to give you a copy of them.) In this personal medical history it’s important to be complete and accurate and as specific as possible. It’s also a good idea to include the names, addresses, and especially phone numbers of all your doctors and other healthcare professionals who’ve treated you. If you take dietary supplements, aspirin, or herbal products, include them.
Once this is written down and dated, update it at least yearly and keep a copy handy. If you’ve entered it on your computer, you can copy it to a USB stick memory and keep it on your keychain in case you wind up in the Emergency Room. Just give it to the ER Staff and tell them to print it for your ER doctor to see and for a copy to be kept with your chart.
3. Work with your doctor and other health care professionals.
One way is to share your written medical history with them. Whenever you go to your doctor, take a minute or two to write down all the things that are on your mind about your health and be sure that your physician addresses them AND that you write down his or her responses to your questions. Sometimes it’s good, within the bounds of your privacy, to share your draft list with your spouse or another family member. They may have noticed something that you forgot to put on your list. Another reason to share is that they will reinforce the idea that you need answers to your concerns and you need to write them down.
If your doctor recommends an invasive test or a surgical procedure, part of that recommendation should include the goals and risks of what’s been recommended. If you do not fully understand what’s been recommended, and why, and what the risks, if any, are, just say NO until you understand everything and decide to go ahead with it. Remember, don’t be shy!
4. Involve a family member or friend in your care.
Again, this is just common sense. If you have any condition that affects your memory or judgment, it’s important to have someone that you trust who cares about you with you when you see your doctor. Ideally, you will have shared your written questions and concerns with that person so that, even if you forget to ask or record the answers, they will remember and get it done.
5. Follow the treatment plan agreed upon by you and your doctor.
Write down any instructions that you receive or get them from your doctor in written form. It’s ok to ask how much something costs, whether it’s a medicine, a test, or whatever. If the doctor doesn’t know, they should and your question should motivate him or her to find out. Take any and all medicines just the way they are prescribed. If something is to be taken once or twice a day, that’s easy; just take in the morning or the evening or at both times. If something is to be taken three or four times a day, it’s a good idea to ask your doctor so that you both have aligned your expectations about timing. If a medicine makes you feel bad or makes you sick, the first thing to do is to CALL the doctor who prescribed it. If you can’t get a call back pester them until you do so that 1. your doctor knows what’s going on and 2. they will give you advice about what to do, whether it is to take a med with meals, or decrease the frequency of doses, or change to a different med or just stop it. You should expect that your doctor will make a note in your medical record of your reaction and what he or she did about it. If a medicine makes you sick and, instead of CALLING the prescribing physician, you just take it less frequently than prescribed or even stop taking it, you may be endangering your health—and your doctor still thinks you are taking it as prescribed!
Remember the title of this very helpful fact sheet:
What You Can Do to Make Healthcare Safer
If you have a topic you’d like me to address, just send me an email via
the “Contact” page of this site.
Some Reasons to Oppose the NIH Draft Guidelines for (Destructive) Human Embryonic Stem Cell Research
Posted by drbob2 on Jun 1, 2009
As a physician and father of seven wonderful children who began their lives as embryonic individuals, I write to present my comments in opposition to the DRAFT National Institutes of Health Guidelines for Human Stem Cell Research presented over the April 17, 2009 name of Dr. Raynard S. Kington, Acting Director, NIH. Guidelines
Of course, as one who adheres to the Hippocratic Oath, my opposition to the proposed Guidelines is based primarily on their inherent and unwarranted devaluation of human life, which, in this context, is to be killed in the name of “science.” There are many more reasons to oppose these Guidelines.
Throughout the Guidelines, cells derived from the intentional killing of little human beings are described in terms of their “use.” When they are deemed, by their parent or donor owners, to no longer be useful to provide an implanted embryo, intrauterine fetus, and born child, they are relegated to be killed and used in the name of “research.” Echoes of the testimony provided at the Doctors Trials at Nuremberg in the late 1940’s (and of the Tuskegee Study) are now sounding loudly in America. Is anyone in Washington listening? One is reminded that the secret of Schindler’s List was that Oskar Schindler found ways to portray the usefulness of born human beings to bureaucrats of the Third Reich. In so doing, he saved many otherwise slated for death or lethal “research” at the hands of physicians and scientists. Pragmatic Utilitarianism is not only impractical but, neither then and there nor here and now, is it anything but barbarism.
In my second paragraph I noted that my unfailing objection is rooted in the immoral and unethical action of directly killing one human being for some reputed “higher purpose.” When that “higher purpose” is based on smoke, mirrors, and fantasy, the entire enterprise becomes incredible and demeans its proponents. Human embryonic stem cell research has been carried on for over 10 years in the U.S., largely but not entirely funded by non-public dollars. At this time, before EO 13505, our country was spending more on this destructive research each year than the rest of the world combined!
In spite of this level of funding for this period, no human clinical trials have even begun, although one—very cautious and very small—has now been approved by the FDA. The scientific reasons are, no doubt, known to the author(s) of the Guidelines: human embryonic stem cells have not been controllable and are prone to form a variety of tumors; additionally, human embryonic stem cells always carry a genome distinct from any putative patient. Although this latter impediment may be addressed with immunosuppressive drugs, when balancing that regimen against the currently demonstrated effectiveness of cell therapies employing the patient’s own stem cells (without immunosuppression) or those employing donated but matched adult stem cells (with immunosuppression), the risks of using embryonic stem cells tips the scales against them.
It would appear, from my reading of the Guidelines, that Dr. Kington has made an unwarranted and unsupportable interpretation of the Dickey-Wicker Amendment, here presented as currently in force.
Dickey-Wicker Amendment
(enacted on March 11, 2009 as part of the Omnibus Appropriations Act, 2009,)
SEC. 509. (a) None of the funds made available in this Act may be used for–
(1) the creation of a human embryo or embryos for research purposes; or
(2) research in which a human embryo or embryos are destroyed, discarded, or knowingly subjected to risk of injury or death greater than that allowed for research on fetuses in utero under 45 CFR 46.208(a)(2) and Section 498(b) of the Public Health Service Act [1](42 U.S.C. 289g(b)) (Title 42, Section 289g(b), United States Code).
(b) For purposes of this section, the term “human embryo or embryos” includes any organism, not protected as a human subject under 45 CFR 46 (the Human Subject Protection regulations) . . . that is derived by fertilization, parthenogenesis, cloning, or any other means from one or more human gametes (sperm or egg) or human diploid cells (cells that have two sets of chromosomes, such as somatic cells).
To present these Guidelines as approving funding of research using human embryonic stem cells that were “derived” i.e. obtained by killing an embryonic human being, is disingenuous at best if it is meant to be within the actions approved by Dickey-Wicker. To consider this further, these Guidelines are meant to divorce themselves from the actual killing—presumably not funded by NIH—how can the “Eligibility” provisions not be interpreted as a wink and a nod to those who, although, perhaps, not directly funded by tax dollars, must meet specific NIH requirements so that their unfunded killing actions are allowed to generate a funding stream by using the products of the killing? If the “eligibility” provisions are not a clear attempt to tacitly approve actions contrary to the language and intent of Dickey-Wicker what are they?
Penultimately, these Guidelines become patently incredible when they promote the immoral, unethical, and increasingly outdated and unworkable destruction of human beings by providing the accurate definition of human embryonic stem cells as “cells derived from human embryos (that) are capable of dividing without differentiating for a prolonged period in culture, and (that) are known to develop into cells and tissues of the three primary germ layers.” Contrast that definition with the same Guidelines definition of human induced pluripotent stem cells: “cells that are capable of dividing without differentiating for a prolonged period in culture and (that) are known to develop into cells and tissues of the three primary germ layers.” Since the defined characteristics, as presented in the Guidelines, are indistinguishable, and since one involves the killing of a human being without their foreknowledge or consent, the reasonable reader must ask why Executive Order 13505 was issued and why these Guidelines were drafted?
It is clear the answer to that question is that President Obama is enthralled by the notion that human embryos are human enough to be used but not human enough to be protected. It follows that President Obama is here engaged in fulfilling a campaign promise to require taxpayer funding of increasingly irrelevant “research” which requires the killing of little human beings. As such the Executive Order and these Guidelines are morally corrupt. They devalue human life and demean and degrade scientific inquiry.