STAT: Harvard researcher and CBH collaborator Lisa I. Iezzoni, studies health care disparities for people with disability. In this First Opinion, Dr. Iezzoni shares her personal experiences of feeling dissatisfied, not recieving the same quality health care as people without disability. Her recent research in Health Affairs, co-authored by Eric G. Campbell and Julie Ressalam, found that just 56.5% of doctors strongly agreed that they welcomed patients with disabilities into their practices, and only 40.7% of doctors surveyed reported feeling very confident about their ability to provide the same quality of care to patients with disabilities.
WASHINGTON POST: Intensive care units are full and regular hospital floors are “bursting at the seams” as people stream into emergency departments. But not all cases that arrive are true emergencies. Center Director Matthew Wynia, MD, MPH, who helped write Colorado's crisis standards of care said, “What’s changed is EMS can now come and say, ‘You know, we’d normally bring you into the emergency department, but you don’t meet the criteria given the current surge.' Patients with less-urgent needs may be taken to urgent-care centers and other alternative sites when appropriate, according to the guidelines."
THE OREGONIAN: “It’s human nature that people don’t want to acknowledge that terrible things are happening,” said Dr. Matthew Wynia, Director of the Center for Bioethics and Humanities. “Particularly in a competitive system, you’re not going to have one of them say, ‘Look we’re harming patients right now because we’re overwhelmed.’ Everyone ends up saying we’re close but we’re not hurting anyone yet, when in fact patients are being hurt right now.”
NATURE: CBH Senior Scientist, Lisa Bero, PhD, suggests universities, journals and publishers should implement data checks sooner rather than later. This means sharing information as well as technical resources, such as expertise in statistical and software tools to detect anomalies. They must also make fraud-detection tasks routine. Too often, investigations focus on pinning down blame, or sweeping misconduct under the rug. Only through a widespread community effort can we ferret out fraud.
JOURNAL OF GENERAL INTERNAL MEDICINE: Eric G. Campbell, Matthew DeCamp, Hilary Lum and co-authors surveyed 543 physicians to understand the experiences and perspectives of MAiD providers in Colorado. Their findings show that while those who have participated in MAiD largely report the experience to be emotionally fulfilling and professionally rewarding, both those who have participated and those who have not report several critical barriers to participation, especially around clinical knowledge, time and emotional investments, and professional ethics concerns.
NEW YORK TIMES: There is a greater menu of Covid pills and infusions now than at any point in the pandemic. The problem is that the supplies of those that work against the Omicron variant are extremely limited. Unvaccinated people are at far greater risk of hospitalization or death from Covid. But giving them priority access to treatments leaves people feeling “like you are rewarding intransigence,” said Center Director Dr. Matthew Wynia.
AMA JOURNAL OF ETHICS: Why Does Medical Participation in the Holocaust Still Matter? by Tessa Chelouche, MD and Matthew K. Wynia, MD, MPH, was the 6th most read article in the AMA Journal of Ethics Top Ten of 2021. The #6, #7 and #8 most read articles all were from the January 2021 issue, "Legacies of the Holocaust in Health Care."
HEALTH AFFAIRS: Lisa I. Iezzoni, Eric G. Campbell, Julie Ressalam and co-authors surveyed of 714 US physicians in outpatient practices, 35.8 percent reported knowing little or nothing about their legal responsibilities under the ADA, 71.2 percent answered incorrectly about who determines reasonable accommodations, 20.5 percent did not correctly identify who pays for these accommodations, and 68.4 felt that they were at risk for ADA lawsuits.
AMERICAN JOURNAL OF BIOETHICS: Authors Rachel Fabi and Daniel S. Goldberg contend that bioethics funders’ focus on genetics, genomics, neuroethics, and the ethics of other emerging technologies disproportionately harms People of Color, who are more likely to experience inequities in health care and the social determinants of health. Neglecting to fund bioethics research into questions of population health in favor of flashier topics means that ethical questions about the root causes of, for instance, the egregiously high rates of maternal mortality among Black women in the United States are less fundable and therefore less likely to receive scholarly attention. They conclude that our community must endeavor to lift up the voices of those most affected by health inequities, including through community-based participatory research and other methods that bring to the fore the lived experiences of the victims and survivors of social injustice.
HEALTH AFFAIRS: Physicians’ Perceptions Of People With Disability And Their Health Care, co-authored by Eric G. Campbell, PhD and Julie Ressalam
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NATIONAL ACADEMY OF MEDICINE: Duty to Plan: Health Care, Crisis Standards of Care, and Novel Coronavirus SARS-CoV-2, co-authored by Matthew Wynia, MD, MPH, was the National Academy of Medicine's 9th most read perspective paper in 2021, and was in the top 5% of all 2021 research articles scored by Altmetric. The paper was cited by over 100 national news outlets and read in 8 countries besides the US.
THE CONVERSATION & SALON: Center Director Matthew Wynia, MD, MPH believes that by the end of December, our health system in Colorado could be 10% over capacity across all our hospitals, in both intensive care units and regular floors. When hospitals are full, we are forced into making triage decisions, but unlike last spring, the situation has changed. Today our hospitals have plenty of ventilators, but not enough staff to run them. Stress and burnout are taking their toll.
BOSTONIA: Warren Binford travels the world advocating for children who are trafficked, abused, traumatized, exploited, or forced to migrate because of violence, poverty, or the climate crisis. Binford “comes with a whole host of skills you don’t appreciate until you see how she sits down and works with children,” says Michael Garcia Bochenek, who wrote the foreword to Hear My Voice. “To put children at ease and elicit information without coercion, to make it participatory, is amazing to watch. She’s a force of nature.”
GREELEY TRIBUNE: In most states, including Colorado, boards of health are able to add more vaccines to their lists of school immunization requirements. So there is a solid legal ground for state officials to require COVID-19 vaccines for schoolchildren, said Daniel Goldberg, JD, PhD, a public health law expert at the Center for Bioethics and Humanities. “Can they do it: absolutely,” he said. “Will they do it?
KUNC COLORADO EDITION: Stigma scholar, Daniel Goldberg, JD, PhD says, “The best evaluations we have on stigma are very clear that stigma flows from things like power, oppression, race, class, gender, ability or disability status; these same oppressions that are driving differences between people are the ones that create stigma, that separate in-groups from out-groups, which is what stigma is. What can we do to move the needle on stigma structurally, to change some of the structures that drive stigma against marginalized, victimized and vulnerable groups?
DENVER POST: Colorado is in the process of updating the state’s crisis standards of care as the COVID-19 situation worsens. The frustration that some vaccinated people feel is understandable, but it’s not acceptable to withhold care from people because they may have contributed to their illness, said Matthew Wynia, Director of the Center for Bioethics and Humanities. Even measures that some people might feel are punitive, like withholding a liver transplant if a person is unable to stop drinking heavily, are focused on the future and how likely it is that the surgery will save a life, he said. “We don’t punish people for their bad decisions,” he said.
JAMA OPTHALMOLOGY: Authors Lisa I. Iezzoni, MD, MSc; Sowmya R. Rao, PhD; Julie Ressalam, MPH; Dragana Bolcic-Jankovic, PhD, and Eric G. Campbell, PhD surveyed 1,400 physicians across 7 specialties (family medicine, general internal medicine, rheumatology, neurology, ophthalmology, orthopedic surgery, and obstetrics-gynecology) about their use of basic accommodations when caring for patients with significant vision limitations. They found that less than one-tenth of physicians practicing in the US who care for patients with significant vision limitations usually or always describe clinic spaces or provide large-font materials, and less than one-third of ophthalmologists do so. In an invited commentary, Jacqueline Ramke, MPH, PhD, believes that unique barriers that people with vision impairment face have been ignored in health care settings, which translates to broader health inequities. Ramke calls for creation of accessible health care environments which are neccessary for equity, autonomy, and the rights of people with vision impairment.
KUNC: In 2018, Colorado launched “Lift The Label,” an opioid anti-stigma public awareness campaign. Daniel Goldberg, JD, PhD studies laws and policies which deeply stigmatize persons who use drugs or persons who live with substance use disorder. One of his suggestions was to acknowledge that stigma “doesn’t exist in a vacuum. It’s a function of social power.” Black and brown communities and other marginalized groups are more likely to experience intersecting forms of stigma (like a pain condition and racial discrimination) at the same time, he said.
WYOMING PUBLIC RADIO: Society has also lost control of the ability to say who should and should not get a booster, said Matthew Wynia, MD, MPH. "The minute we started distributing the vaccines through individual doctor's offices and pharmacies and outside of big health systems and mass vaccination sites, where you had to register, we kind of lost control of the allocation scheme," Wynia said. "So at the moment ... if you walk into a Walgreens and say, 'I want to get a booster,' you're probably going to get a booster."
FACTCHECK: “We are not using vaccination status in making triage decisions. We are treating everyone the same according to their medical needs,” Center Director Matthew Wynia said. “Bottom line: health care professionals don’t punish people for making bad medical decisions, even when those decisions harm both themselves and others.”