Curious Bioethics: November 24, 2024
IV fluid shortage, GA dismisses maternal mortality committee, abusive urologist sentenced
Note: Taking care of yourself may mean skipping this week’s content, and that’s ok. Today’s 3rd news piece includes a story of SA and child abuse.
In today’s curated collection, you’ll find:
🗞️Bioethics News: IV fluid shortage persists, Georgia dismisses maternal death oversight committee, abusive urologist sentenced to life in prison
📚Recommended Reading: on living in fear of Alzheimer’s Disease
🦉Educational Opportunities: How Healers Became Killers: Nazi Doctors and Modern Medical Ethics
Happy Sunday, My Curious Readers!
Thank you so much for those of you who took the time to reply to my last few essays. I appreciate hearing from you!
This weekend, we got our family caught up on flu and COVID vaccines. I’d gotten mine at work but needed to find a local pharmacy equipped to vaccinate kids. Thankfully, the process of booking multiple appointments has improved dramatically in the years since the pandemic began!
My kids were not impressed with the pharmacy’s branded bandaids, so they decorated themselves with corgi butt stickers. Feel free to do the same!
🗞️ Bioethics in the News
North Carolina Baxter Plant Ships first IV Fluids post-Hurricane Helene
National IV Fluid and Dialysis Fluid Shortages Persist
While invisible to most people out of the hospital and out of dialysis centers, the US is still in a significant IV fluid shortage after Hurricane Helene took out a major US production facility.
If resources become extremely scarce, a hospital can end up in crisis care - where there isn’t enough of a specific resource to provide the standard of care treatments to patients. One way to prevent that during the IV fluid shortage is to cancel or delay some surgeries. Hospitals are moving fluids around and reducing IV fluid infusions, trying to conserve supplies for people who can’t safely receive alternative treatments for hydration.
Thankfully, the Baxter facility continues to make progress, and late last week was able to ship out 1-liter IV bags. Hospitals and dialysis centers are eager for dialysis fluid production to restart. Baxter projects this will be possible by early December.
Georgia Dismisses All Members of Maternal Mortality Committee After Leak About Patient Deaths
In September 2024, ProPublica released a story about deaths in Georgia after physicians delayed offering appropriate medical and surgical care in the setting of Georgia’s severe abortion restrictions. This included the story of a young mother, Amber Thurman, who died of sepsis after her dilation and evacuation was delayed for almost a full day. She is survived by her young son.
When the Georgia Department of Public Health couldn’t find the leak, they dismissed all 32 committee members.
In a November 8th letter, Dr. Kathleen Toomey, commissioner of the state Department of Public Health wrote “Confidential information provided to the Maternal Mortality Review Committee was inappropriately shared with outside individuals… Even though this disclosure was investigated, the investigation was unable to uncover which individual(s) disclosed confidential information… Therefore, effective immediately the current MMRC is disbanded, and all member seats will be filled through a new application process.”
Urologist and sexual predator Dr. Darius Paduch sentenced to life in prison
On Wednesday, November 20, 2024, urologist Darius Paduch, was sentenced to life in prison for sexually abusing patients, including children.
Paduch, former director of sexual health and medicine at NewYork-Presbyterian/Weill Cornell Medicine and Northwell Health, abused his position of power between at least 2007 and 2022. He used his power to lead survivors to believe that the abuse was medically indicated - a common tactic among abusive physicians. After being initially charged in December 2022, more survivors came forward, leading to a superseding indictment in October 2023. He was convicted in Federal court in May 2023. There are over 300 reported survivors. Given the generally low rate of reporting of sexual abuse combined with the number of years Paduch practiced, the number of actual survivors is likely in the thousands.
“Darius Paduch was a sexual predator who preyed on patients seeking treatment for sensitive medical issues. He used his position as a renowned urologist at prestigious hospitals to sexually assault vulnerable patients, including children, to gratify his own sexual desires. Paduch’s abuse was perverse and pervasive, spanning over a decade and victimizing patients both inside and outside of hospital rooms. He repeatedly violated his oath to ‘Do No Harm.’ Today’s sentence demonstrates that medical providers who exploit their position of trust to commit sexual abuse will be held accountable for their conduct.” - U.S. Attorney Damian Williams
I’ve written about poor self-regulation of physicians who sexually assault patients and how our medical culture often tolerates and covers up abuse. Physician leadership is part of the problem.
Nationwide Recall of Clonazepam Orally Disintegrating Tablets
Endo, the company that manufactures the popular anti-anxiety drug clonazepam, expanded its recall of orally disintegrating tablets due to mislabeling the dose of drug in its packages. The original recall was announced in July 2023.
Boxes of clonazepam may be mislabeled with the incorrect dose of medication. This can pose life-threatening risks to patients who may have boxes containing higher-dose pills than labeled. An overdose of clonazepam can cause sedation, confusion, dizziness, diminished reflexes, loss of muscle coordination (ataxia), and low muscle tone (hypotonia).
If you or a loved one take clonazepam, you can review the impacted lot numbers here. Check the box and the pill packet(s) inside to check that the dosage on the box and the pill packets are the same.
📚 Recommended Reading
An Ageist Disease: On Living in Fear of Alzheimer’s
Andrea Gilats Explores Confounding Questions of Aggression, Identity Shifts, and Care for the Afflicted
Read on LitHub.
“The one disease I fear most is Alzheimer’s, and I am sure that I am not the only one. Our fear of Alzheimer’s, which recent research suggests may have been the third leading cause of death in the pre-pandemic United States, far outranks our fear of heart disease and cancer, the first and second leading causes of pre-pandemic deaths.”
~Andrea Gilats
🦉Educational Opportunities
No registration is required! Just go straight to YouTube for this on-demand bioethics education.
How Healers Became Killers: Nazi Doctors and Modern Medical Ethics
by Matthew Wynia, MD, MPH
The video is a recording of a lecture bioethicist Dr. Matthew Wynia gave in January 2024.
“Presentation by Matthew Wynia, MD, MPH, Professor of Medicine at the University of Colorado School of Medicine and Director of the Center for Bioethics and Humanities. This Program on International Holocaust Remembrance Day, January 29, 2024, was co-sponsored by the Center for Bioethics and Humanities-Holocaust, Genocide, and Contemporary Bioethics Program at the University of Colorado Anschutz Campus, ADL Mountain States, National Jewish Health, and the University of Denver, Holocaust Awareness Institute.”
You can also read “The Lancet Commission on medicine, Nazism, and the Holocaust: historical evidence, implications for today, teaching for tomorrow.” While the associated essays appear to be behind a firewall, you can read them for free by registering your email address.
That’s it!
As always, thanks for being curious!
Hit reply and let me know what ethics issues you are most curious about this week—I’d love to hear from you!
See you next week!
Be Well & Be Curious,
Alyssa
