Drug companies pay doctors over A$11 million a year for travel and education. Here’s which specialties received the most

Monster Ztudio/Shutterstock Barbara Mintzes, University of Sydney and Malcolm Forbes, Deakin University

Drug companies are paying Australian doctors millions of dollars a year to fly to overseas conferences and meetings, give talks to other doctors, and to serve on advisory boards, our research shows.

Our team analysed reports from major drug companies, in the first comprehensive analysis of its kind. We found drug companies paid more than A$33 million to doctors in the three years from late 2019 to late 2022 for these consultancies and expenses.

We know this underestimates how much drug companies pay doctors as it leaves out the most common gift – food and drink – which drug companies in Australia do not declare.

Due to COVID restrictions, the timescale we looked at included periods where doctors were likely to be travelling less and attending fewer in-person medical conferences. So we suspect current levels of drug company funding to be even higher, especially for travel.

What we did and what we found

Since 2019, Medicines Australia, the trade association of the brand-name pharmaceutical industry, has published a centralised database of payments made to individual health professionals. This is the first comprehensive analysis of this database.

We downloaded the data and matched doctors’ names with listings with the Australian Health Practitioner Regulation Agency (Ahpra). We then looked at how many doctors per medical specialty received industry payments and how much companies paid to each specialty.

We found more than two-thirds of rheumatologists received industry payments. Rheumatologists often prescribe expensive new biologic drugs that suppress the immune system. These drugs are responsible for a substantial proportion of drug costs on the Pharmaceutical Benefits Scheme (PBS).

The specialists who received the most funding as a group were cancer doctors (oncology/haematology specialists). They received over $6 million in payments.

This is unsurprising given recently approved, expensive new cancer drugs. Some of these drugs are wonderful treatment advances; others offer minimal improvement in survival or quality of life.

A 2023 study found doctors receiving industry payments were more likely to prescribe cancer treatments of low clinical value.

Our analysis found some doctors with many small payments of a few hundred dollars. There were also instances of large individual payments.

Why does all this matter?

Doctors usually believe drug company promotion does not affect them. But research tells a different story. Industry payments can affect both doctors’ own prescribing decisions and those of their colleagues.

A US study of meals provided to doctors – on average costing less than US$20 – found the more meals a doctor received, the more of the promoted drug they prescribed.

Pizza anyone? Even providing a cheap meal can influence prescribing. El Nariz/Shutterstock

Another study found the more meals a doctor received from manufacturers of opioids (a class of strong painkillers), the more opioids they prescribed. Overprescribing played a key role in the opioid crisis in North America.

Overall, a substantial body of research shows industry funding affects prescribing, including for drugs that are not a first choice because of poor effectiveness, safety or cost-effectiveness.

Then there are doctors who act as “key opinion leaders” for companies. These include paid consultants who give talks to other doctors. An ex-industry employee who recruited doctors for such roles said:

Key opinion leaders were salespeople for us, and we would routinely measure the return on our investment, by tracking prescriptions before and after their presentations […] If that speaker didn’t make the impact the company was looking for, then you wouldn’t invite them back.

We know about payments to US doctors

The best available evidence on the effects of pharmaceutical industry funding on prescribing comes from the US government-run program called Open Payments.

Since 2013, all drug and device companies must report all payments over US$10 in value in any single year. Payment reports are linked to the promoted products, which allows researchers to compare doctors’ payments with their prescribing patterns.

Analysis of this data, which involves hundreds of thousands of doctors, has indisputably shown promotional payments affect prescribing.

Medical students need to know about this. LightField Studios/Shutterstock

US research also shows that doctors who had studied at medical schools that banned students receiving payments and gifts from drug companies were less likely to prescribe newer and more expensive drugs with limited evidence of benefit over existing drugs.

In general, Australian medical faculties have weak or no restrictions on medical students seeing pharmaceutical sales representatives, receiving gifts, or attending industry-sponsored events during their clinical training. They also have no restrictions on academic staff holding consultancies with manufacturers whose products they feature in their teaching.

So a first step to prevent undue pharmaceutical industry influence on prescribing decisions is to shelter medical students from this influence by having stronger conflict-of-interest policies, such as those mentioned above.

A second is better guidance for individual doctors from professional organisations and regulators on the types of funding that is and is not acceptable. We believe no doctor actively involved in patient care should accept payments from a drug company for talks, international travel or consultancies.

Third, if Medicines Australia is serious about transparency, it should require companies to list all payments – including those for food and drink – and to link health professionals’ names to their Ahpra registration numbers. This is similar to the reporting standard pharmaceutical companies follow in the US and would allow a more complete and clearer picture of what’s happening in Australia.

Patients trust doctors to choose the best available treatments to meet their health needs, based on scientific evidence of safety and effectiveness. They don’t expect marketing to influence that choice.

Barbara Mintzes, Professor, School of Pharmacy and Charles Perkins Centre, University of Sydney and Malcolm Forbes, Consultant psychiatrist and PhD candidate, Deakin University

This article is republished from The Conversation under a Creative Commons license. Read the original article.

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California dentist pleads guilty to stealing $500,000 in COVID-19 relief money

Ranjan Rajbanshi, D.D.S., 46, of Bakersfield and Santa Barbara, California, pleaded guilty August 21, 2023, to stealing $500,000 in COVID-19 relief money.

• The guilty plea was announced by U.S. Attorney for the Eastern District of California Phillip A. Talbert.
• According to the press release which quoted from court records, Rajbanshi ran a dental practice in Bakersfield and Santa Barbara.
• From April 2020 through February 2022, he received more than $850,000 in COVID-19 relief money from the Small Business Administration (SBA) and the U.S. Department of Health and Human Services (HHS). He represented to the government that he would only use the relief money for specified business purposes such as facility costs, payroll, and protective equipment for him and his staff.
• Rajbanshi subsequently used $500,000 of the relief money “for improper personal expenditures such as investments,” the press release said. He has agreed to pay that money back to the government before his sentencing. He is scheduled to be sentenced by U.S. District Judge Ana de Alba on Dec. 4, 2023, when he faces a maximum statutory penalty of 10 years in prison and fine of $250,000. The actual sentence, however, will be determined at the discretion of the court after consideration of any applicable statutory factors and the Federal Sentencing Guidelines, which take into account a number of variables.The Justice Department said anyone with information about allegations of attempted fraud involving COVID-19 can report it by calling the Department of Justice’s National Center for Disaster Fraud (NCDF) Hotline at 866-720-5721 or via the NCDF Web Complaint Form at justice.gov.California dentist pleads guilty to stealing $500,000 in COVID-19 relief money

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‘KGF’ actor Harish Roy reveals he has throat cancer

‘KGF’ actor Harish Roy, who played the role of Khasim Chacha in the movie, has been diagnosed with cancer. The actor recently revealed this information in an interview.

Harish said he noticed a small swelling in the throat about a year ago. However, he was not in a condition to undergo surgery at that time. “My children are very young and I was scared to undergo throat surgery. So, I wanted to finish the KGF movie. Then got a lot of fame and took a risk. but that cancer spread to my lungs and water accumulated in my lungs,” he told the interviewer.

Harish Roy often suffered from shortness of breath during the shooting of the movie ‘KGF’. He then tested and realized that he need to get treated quickly. But he did not have the money to get treatment in a private hospital. Later, on the advice of a friend, he started treatment at Kidwai Cancer Institute, Bangalore. But this did not improve his condition. The doctor said that he is in the “fourth stage” of cancer. Later, they started treating him again.

It is learned that the actor spends Rs 3 lakh on medicines every month. Besides, he has already undergone surgery once. “The doctor told me that it is possible to recover. After the treatment, I feel better than before,” he said.

Harish said that a star actor extended a helping hand to him. Not only this, many Kannada cinema actors and filmmakers have already pledged their support to him.

Harish Roy acted as Khasim Chacha in the ‘KGF’ movie series. The first movie of this series was released in 2018. ‘KGF 2’ was released this year. This movie earned 1000 crore rupees at the box office.DailyBangladesh/AS, ‘Source: https://www.daily-bangladesh.com

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Pfizer, Moderna vaccines cut COVID-19 risk by 91 per cent: Study

JUL 07, 2021 People who receive COVID-19 vaccines by Pfizer and Moderna are up to 91 per cent less likely to develop the disease, according to a US study which also suggests that the preventives reduce the severity of symptoms and duration in those who still get an infection. The research, published in the New England Journal of Medicine on June 30, is among the first to show the benefits of mRNA vaccines even among those who experience breakthrough infections -- testing positive after immunisation. The mRNA vaccines by Pfizer and Moderna contain genetic instructions for our cells to make the spike protein of the SARS-CoV-2, which the virus uses to infect and enter the human cells. Our immune system then builds an immune response against the spike protein, and learns how to fight off the coronavirus if we encounter it in future. "One of the unique things about this study is that it measured the secondary benefits of the vaccines," said study co-author Sarang Yoon, an assistant professor at the University of Utah, US. The study was designed to measure the risks and rates of infection among those on the front lines of the pandemic -- doctors, nurses, and first responders. "These are the people who are getting exposure to the virus day in and day out, and the vaccine protected them against getting the disease. Those who unfortunately got COVID-19 despite being vaccinated were still better off than those who didn''t," he added. The study found that mRNA COVID-19 vaccines were 91 per cent effective in reducing risk for infection once participants were "fully" vaccinated, two weeks after the second dose. The researchers also found that the vaccines are 81 per cent effective in reducing risk for infection after "partial" immunisation, two weeks after the first dose was given. The study recruited 3,975 participants at eight sites in the US. Participants submitted samples for COVID-19 testing on a weekly basis for 17 weeks between December 13, 2020 and April 10, 2021. Only 204 (5 per cent) of the participants eventually tested positive for SARS-CoV-2, the virus that causes COVID-19. Of these, 156 were unvaccinated, 32 had an indeterminate vaccine status, and 16 were fully or partially vaccinated. The fully or partially vaccinated participants who developed breakthrough had milder symptoms than those who were unvaccinated. In those who developed a breakthrough infection, the presence of fever was reduced by 58 per cent per cent among vaccinated people, and the days spent sick in bed were reduced by 60 per cent. Detection of the virus was reduced by 70 per cent percent among those with breakthrough infections, from 8.9 days to 2.7 days. These findings also suggest that fully or partially vaccinated individuals who get COVID-19 might be less likely to spread the virus to others. The researchers found that infected study participants who had been fully or partially vaccinated when infected had 40 per cent less detectable virus in the nose and did so for six fewer days compared to those who were unvaccinated. "I hope these findings reassure the public that mRNA COVID-19 vaccines are safe and protect us from this severe disease," Yoon added. Copyright © Jammu Links News Source: Jammu Links News

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India's daily Covid cases double to more than 2 lakh in just 10 days

• India added a record over 2 lakh new Covid-19 cases in the past 24 hours, taking the number of active cases in the country to 1,40,74,564, figures released by the union health ministry showed.
• This is also the fastest rise in Covid cases in the country, with the number of daily infections doubling in just 10 days since the beginning of this month.
• The ministry also reported 1,038 deaths due to Corona across the country on Tuesday, which took the cumulative toll to 1,73,123.
• India has already overtaken Brazil to become the country with the second-highest number of Covid-19 cases, after the United States, which counts 31.4 million Covid-19 cases.
• With over 1 lakh fresh infections per day for the ninth consecutive day, India added 13,88,515 cases in just nine days.
• With the steady increase in active cases for the 36th day in a row, the caseload has increased to 10.46 per cent of the total infections, while the recovery rate has dropped to 88.31 per cent.
• The number of Covid-19 infections in the country, which crossed the 2 million mark on 7 August 2020, rose to 3 million on 23 August, to 4 million on 5 September, to 5 million on 16 September, to 6 million on 28 September, to 7 million on 11 October, to 8 million on 29 October, to 9 million on 20 November and surpassed the 100 million mark on 19 December.
• It has now had more than 13.5 million confirmed cases in total, which is more than the caseload in Brazil, and is now only behind the worst-hit United States.
• According to the ICMR, 26,20,03,415 samples have been tested till 14 April, including 13,84,549 samples being tested on Wednesday.
• The surge in cases has stretched the country’s fragile health infrastructure too far, with several states reporting shortages of intensive care (ICU) beds and oxygen cylinders.
• In Maharashtra, the most-affected state, two huge complexes for patients are being set up as the state government initiated a range of curbs on movement, gatherings and commercial establishments for two weeks.
• Hospitals and doctors in Maharashtra as well other regions including Gujarat and Delhi in the north reported chaotic scenes as healthcare facilities were overwhelmed with a surge in admissions of COVID-19 patients.
• Beginning Wednesday night, all shops, malls and e-commerce deliveries except of essential items like food, groceries and medicine have been suspended until 1 May.
• All manufacturing units except export-oriented ones and those manufacturing essential items would also be closed. Bars and restaurants have already been closed and gatherings of more than five people are banned across the state.
• Delhi recorded 17,282 cases over the past 24 hours – the highest single-day figure so far – as the city was running short of ICU beds for COVID-19 patients, with only about 171 with ventilators available late on Wednesday.
• With more fatalities reported, there has been a huge burden on crematoriums and burial grounds in the capital city.
• Television channels also showed angry relatives of a patient who died after spending hours on a stretcher outside a Covid-19 hospital in Jharkhand state’s capital, Ranchi, where all the beds were reported to be occupied.
• Similar scenes could be seen in neighbouring Bihar’s capital, Patna.Recent regional elections and festivals including the mammoth month-long Kumbh Mela are expected to accelerate the infection rate further, with virologist Shahid Jamil calling them super-spreader events. Source: https://www.domain-b.com/

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Alcoholics get second chance at liver transplants

BioEdge: By Jared Yee, Gravely ill alcoholics who need a liver transplant should not always have to prove they can stay sober for six months to get one, doctors have said in a study. This could inflame the debate about whether people who destroy their organs with alcohol deserve new ones. The small French study showed that patients who received a liver  without the six - month wait  stopped  drinking  after surgery  and  were sober  years later. The study dealt with patients who had such severe hepatitis that it was unlikely they would survive the waiting period. Alcohol can cause liver-destroying illnesses such as hepatitis and cirrhosis. Almost one in five liver transplants in the US go to former heavy drinkers. Transplant hospitals commonly require patients to stop drinking for six months to demonstrate that they will stay on the wagon after they get a new liver. However, drinkers make up only a fraction of patients needing transplants. The French study suggests that dropping the six-month rule for these patients would increase demand for livers by only around 3 percent. Dr Philippe Mathurin of Huriez Hospital in Lille, France, said that the six-month rule is unfair to alcoholics. Many other patients need livers because of other bad lifestyle choices, such as obesity or drug abuse. Dr Robert S Brown Jr, of New York-Presbyterian Hospital/Columbia University Medical Centre, also said the six-month rule needs rethinking. “The challenge of this paper is to come up with better ways, both to treat alcoholism as a disease and to predict who will succeed with transplantation,” he said. ~ Washington Post, Read Full: Alcoholics get second chance at liver transplants, Image: fickr.com

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Doctors going to U.S. for studies will have to sign bond for return

The government on Monday said any doctor going to the US for higher medical studies would have to sign a bond with it before leaving and honour the document by returning to India after finishing the study period. “From this year onwards, any student going for further medical education to the U.S. will have to give us a bond that he will come back after finishing the studies. In the last three years, 3000 doctors went abroad for studies and did not return. Now if a student does not come back from the US, he won’t be allowed to practice there,” Health Minister Ghulam Nabi Azad said. He said the U.S. from this year onwards is insisting on a government NOC to every student enrolling with an American institute for studies.“No other country except the U.S. is asking for this NOC. Those who apply to go to the US for studies from 2012 will have to give us a bond saying they would come back after finishing the studies. If they don’t fulfill the bond obligation, we can write to the U.S. to deny the student permission to practice,” Mr. Azad told reporters in New Delhi. The minister also expressed the hope that the MCI will give its approval to the proposed three-year Bachelor of Rural Health Care course, which seeks to create a separate cadre of public health professionals in the country to serve in rural areas. He said the doctors’ organisations were not interested in the course. “Doctors’ organisations are opposing the course. I have no hesitation in saying that they have a vested interest to increase their practice,” Mr. Azad said. Mr. Azad said there was a paucity of doctors in primary health centres as doctors only wanted to stay in urban areas. “The rural health care course was ready two years ago. The curriculum is also ready. States are free to implement the course, as Assam is doing, but we wanted the MCI’s recognition to ensure uniform standards for the course across India. We hope the MCI will move fast on it,” he said. The course, Mr. Azad said, would create professionals above the level of paramedics and below the level of MBBS doctors. The move is aimed at not just taming the quacks, who have a field day in rural areas in the absence of adequate medical facilities there, but also provide good medical aid to the rural population at their doorstep. It is being opposed by doctors’ lobby as patients from rural areas rush to private practitioners in urban areas, even as doctors’ organisations feel the creation of a new set of professionals would confuse the population and lead to devaluing the doctors, official sources said. Source: The Hans India

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Doctor developing universal snake bite cure

In a potential scientific breakthrough for the treatment of venomous snake bites, a German doctor has been given a grant to develop a universal antidote. Martin Metz, specialist at Berlin's Charite hospital, has figured out a way of alleviating the effects of any venom using one drug. Until now, bite victims have been treated with a species-specific anti-venoms which have to be kept cool and administered under the watchful eye of a doctor – as there is a risk of an allergic reaction. This means lots of people, particularly in developing countries, do not get help in time. But Metz's early testing with a universal cure has proven promising, according to the BZ regional newspaper. “I realized that the human enzyme protease disrupts proteins in all snake venom,” Metz told the paper. Taking mast cells from human enzymes almost completely cuts chance of allergic reaction. Recreated in a laboratory, the enzyme could be carried about by people at risk and injected if necessary, he added. Unlike current anti-venom treatment, Metz's hopefully will not have to be kept cool. It could also prove effective against other animal bites and stings. The World Health Organisation counts snake bites as one of the most often ignored tropical ailments, killing around 125,000 people each year. Thus, “the production of a universal anti-venom has enormous worldwide importance,” said a statement from Else Kröner-Fresenius-Stiftung (EKFS), which awarded Metz the €300,000 grant. Source: SAM Daily Times

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Girl beats leukemia after doctors trick her immune system with HIV virus

The story of a girl who received an experimental treatment for acute lymphoblastic leukemia (ALL) – the most common type of childhood cancer – and responded to that so that eight months after the April 2012 treatment she is still in remission, has spread around the world. Doctors say they have to see the remission go on for five years before they can say for sure the girl is totally cured and give hope to children and adults diagnosed with leukemia. 

Seven-year-old Emma Whitehead was diagnosed with ALL in May 2010. Eighty-five percent of children with ALL are cured after a two-year process of standard chemotherapy, but 15 percent have a type of disease that is resistant to traditional chemotherapy regimens - and that was Emma’s case. After her second round of chemotherapy in February 2012, Emma relapsed, the cancer recurred again. “It was at that point that we made the decision that we needed to go somewhere else,” says Kari, Emma’s father. “We needed to try something new, different and cutting-edge.” Emma was enrolled in a clinical trial at the Children’s Hospital of Philadelphia (CHOP) and found qualified for CTL019 — an experimental T cell therapy for advanced B cell l leukemias and lymphomas. “A subset of cells in the immune system become leukemia. These are called B cells. Another set of cells in the immune system, called T cells, normally recognize and attack invading disease. But in cancers like ALL, the abnormal leukemia cells fly under the radar of the normal T cells that are meant to kill them,” the CHOP says in a statement that explains the experimental treatment. A patient’s T-cells are collected from the blood, and then re-engineered in a lab to recognize and attach to a protein called CD19 that is found only on the surface of B cells. Afterwards, the reengineered T-cells are put back into the patient’s immune system. The staggering fact about the treatment is that it uses a disabled form of HIV to reprogram the immune system. Emma’s first reaction to the treatment was other than anticipated. But with the doctor’s care she managed to recover. Now, eight months after the treatment, Emma has still no disease, though fighting T-cells are still in her body. “The results are dramatic, but it is very early,” said Michael Kalos, director of the translational and correlative studies lab at University of Pennsylvania. “We are actively looking to treat more patients and see how it works.” Ten adult patients and two children underwent the experimental T-cells treatment, nine of them have responded, both children included. However one month after the treatment, the second child relapsed. Researchers are interested in exploring T cell therapy for other types of cancers, Kalos said, citing lung, pancreatic and prostate cancers as three possible targets. According to the World Health Organization, cancer is a leading cause of death worldwide, accounting for 7.6 million deaths (from all types of cancer, around 13% of all deaths) in 2008. The risk for developing ALL is highest in children younger than 5 years of age. The risk then declines slowly until the mid-20s, and begins to rise again slowly after age 50. Voice of Russia, The Huffington Post, The Telegraph, Cancer.org, Source: Voice of Russia

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Boy is world's first to survive being born with heart outside his body

Ryan with his Sister

When Ryan Marquiss was born with his heart outside of his body, doctors didn’t expect him to survive. It is an incredibly rare condition and usually babies are stillborn or die withinthree days. His heart also hadn’t developed and so he only had half a heart - a combination of defects which is so rare that Ryan is the only one of his kind in the world. Doctors advised his devastated parents to terminate the pregnancy when his mother was just 12 weeks pregnant, but they bravely refused. And it is a gamble that has paid off, as Ryan is just about to celebrate his third birthday. Mrs Marquiss, 34, said: ‘We wanted to let nature take its course, so we refused to have the termination. ‘We knew it would be a miracle if he survived the birth but we were unwilling to take matters into our own hands. ‘The doctors told us that no baby with Ryan’s combination of defects had ever survived, so the fact that he is here with us today, is just amazing. He really has astounded everyone.’ Doctors discovered the problem at 12 weeks into his mother’s pregnancy. The incredibly rare defect, ectopia cordis, affects only eight in every million births and ninety percent of these are stillborn or die within three days. And adding to that Ryan was also suffering from hypoplastic right heart syndrome, where only the left side of the heart has developed properly. Mrs Marquiss, who lives with husband Henry, 34, and 
   Ryan                        Before                   And                After                   Surgery

their other children Natalie, seven, and Ainsley, five, in Pennsylvania, USA, said: ‘All the odds were stacked against him.We knew that it was a miracle that he had been born alive with his heart outside his body, but then to have another life-threatening condition of only having half a heart meant that everything was against him surviving.’ Doctors at the Children’s National Medical Centre in Washingtondelivered him at the end of February 2009 by caesarian, helped by a team of 30 medicalprofessionals. Dr Mary Donofrio, Director of the fetal heart programme at the Children’s National Medical Centre said: ‘If he survived the birth his exposed heart likely would become infected and kill him. Even if infection didn’t happen his heart had one working ventricle and he would require open heart surgery to rewire the blood flow through it. ‘I told the family right from the start that if he survived, it was a miracle.’ Mrs Marquiss said: ‘His heart was protruding out of his chest cavity. The heart was only covered by a thin membrane. ‘But he was alive and we just had to pray that he would carry on fighting.’ Ryan had to have an operation at just two weeks old to have a central shunt placed in his heart to ensure proper blood flow. Then he underwent more than a dozen operations over the next two years. He had operations to replumb his heart so that the half a heart would do the job of a full size heart. Doctors also put tissue expanders under his skin to produce more skin so they could use it to cover his exposed heart. Mrs Marquiss said: ‘He has done amazingly well. He has been so brave throughout it, and his sisters have kept him going too. They have been to see him in hospital and made recordings of themselves at home, so Ryan could hear them. ‘He just kept on fighting. He refused to die, and he kept on proving everyone wrong. ‘He will need some sort of chest protection operation in the future but it may be overcome by just wearing some sort of protective padding when he plays sport. He won’t be a competition athlete, but we are hoping he can run around on the playground and climb trees like any other child.’ Ryan’s case has now been reported in a medical journal. Doctors believe that his survival offers hope for other babies with serious heart defects. In the future he may require a heart transplant, but at the moment, he is progressing well. Mrs Marquiss said: ‘He really is a medical miracle. When I look at him running around the playground and playing on the climbing wall, I praise God. Every day with Ryan is one we were told we wouldn’t have. So we cherish each moment.’Source: Ananta-Tec

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After winning the right to die, NY woman wants to live

After winning the right to refuse life-sustaining treatment, a woman in New York has decided that she wants to live. Grace Sung Eun Lee, 28, a financial manager working in Manhattan was so healthy that she was training for a marathon when she became paralysed. Doctors at diagnosed a fast-moving brain stem cancer which will probably kill her within weeks. She is currently at North Shore University Hospital in Manhasset on Long Island. Grace cannot breathe or eat on her own. She can only communicate by blinking or mouthing words. In this diminished state she indicated to hospital staff that she wanted her respirator to be removed to allow her to die. However, her Korean migrant parents sued to stop this. Her father is a Christian pastor and said that Grace, who is a devout woman who ran a church youth group and had done missionary work abroad, was incompetent because of her medication. They contended that refusing treatment is suicide and is gravely sinful and that this could not possibly represent their daughter’s wishes. Last Friday, the case ground to an end. The courts found that Grace was competent to request an end to her treatment and that her parents should not be granted guardianship. “Whatever little power this poor lady has left, she feels empowered that the court has clearly now recognized that this is up to her and only up to her,” said her court-appointed lawyer. And then, in a surprising reversal, Grace decided that she did not want to die and was willing to remain on a ventilator. “When I asked her if she’s doing this to make peace with her parents, she told me she was doing it to make peace with her parents and to make peace with God,” said the lawyer. Dr J. Randall Curtis, director of a palliative care centre at the University of Washington, told the New York Times that this unusually acrimonious case highlighted different approaches to informed consent. “It’s not terribly unusual in our increasingly multicultural society to have this clash, where Western-trained clinicians really view the patient as the sole determinant of all decision-making and the family sees it different.”Source: BioEdge

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Being a doctor in China is a dangerous profession

BioEdge, By Michael Cook: Violence against doctors is increasing in China. China Daily has reported that in 2010, 17,000 violent incidents in about 70% of the country’s hospitals. This includes murder. In late March, a young doctor at the First Affiliated Hospital of Harbin Medical University in northeast China, was knifed to death by an angry patient. This seems to be the sensational tip of an endemic problem. An on-line survey of attitudes towards the recent murder yielded some revealing figures. Only 7% of respondents were sad and 61% were happy. This is far from being an accurate index of public opinion, but it reflects the public’s frustration. Writing in Bloomberg, Adam Minter ventures three reasons. First, China lacks an independent system for dealing with medical malpractice. Some disgruntled patients feel that their only recourse is violence. Second, doctors are paid so badly that many supplement their meagre income with bribes, kickbacks, commissions, and unnecessary expensive procedures. This makes them despised by patients who feel that their illness is being exploited. As one blogger commented: Internet users are happy, of course, not for the innocent medical intern’s death, but instead happy as a kind of vengeful catharsis against the professional ethics of damn doctors who receive red envelopes [filled with cash] and kickbacks! Black hearts and low morals are not natural to doctors, rather the current situation is caused by commerce and imperfect regulations! Bloomberg, Mar 30, Source: BioEdge, Image: flickr.com

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UK teen recovers “fully” after 4 doctor found him “brain dead”

BioEdge, by Michael Cook : Miraculous recoveries from brain trauma are always good news, but they may not be as miraculous as they first seem. However, the Daily Mail’s account of a boy who recovered fully after four specialists declared that he was brain dead makes one question if doctors really understand brain death. Steven Thorpe was 17 when he was involved in a serious car accident in 2008 which left another passenger dead. He had serious injuries to his arm, face and head and was declared “brain dead”. ‘The doctors were telling my parents that they wanted to take me off the life support,” Steven told the newspaper. “The words they used to my parents were “You need to start thinking about organ donations”.’ Fortunately his parents sensed that their son was still there. ‘I think if my dad had agreed with them then I would have been off the life support machine in seconds,’ says Steven sardonically. They contacted a GP with expertise in traditional and alternative medicine and she persuaded another neurologist to examine him. He detected some brain activity and had him released him from his induced coma. Two weeks later he woke up. As the GP said, “one worries that this may happen more often than we know”. A spokesman for University Hospitals Coventry and Warwickshire NHS Trust said: “The injury to Steven’s brain was extremely critical and several CT scans of the head showed almost irreversible damage. It is extremely rare that a patient with such extensive trauma to the brain should survive. We were delighted to see Steven recover.” ~ Daily Mail, Apr 24, Source: BioEdge,

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British doctor may have fathered more than 600 children

BioEdge, By Michael Cook: A British doctor may have fathered more than 600 children by using his own sperm in his London fertility clinic. Toronto film-maker Barry Stevens has researched records of women treated by Dr Bertold Wiesner, and found that two-thirds of offspring conceived through the clinic were his children. Estimates of how many children he fathered range from 200 to 1,000. Dr Wiesner and his wife Mary Barton ran their clinic from the early 1940s until the mid-1960s, offering sperm from intelligent stock to the spouses of infertile middle and upper-class men. Their work was notorious at the time – so much so that it was once denounced in the House of Lords as “the work of Beelzebub”. Dr Barton told a 1959 government forum on artificial insemination: “I matched race, colouring and stature and all donors were drawn from intelligent stock. I wouldn’t take a donor unless he was, if anything, a little above average. If you are going to do it [create a child] deliberately, you have got to put the standards rather higher than normal.” At the time it was thought that the sperm came from several of Dr Wiesner’s contacts, but it now seems that he supplied it when there was a shortage. It was already known that one of the donors, Derek Richter, a neuro-chemist, had fathered more than 100 of the clinic's children. Mrs Barton later destroyed many of the medical records, meaning most of those conceived there have no idea of their true family history and blood ties. One of the men who discovered that Dr Wiesner was his biological father, David Gollancz, told the Daily Mail, that he opposed sperm donor anonymity and wanted to see the name of sperm or egg donors placed on birth certificates. “Most recipient parents don’t tell their children they are conceived this way, meaning they would never know to search for a donor father. People have a right to know about their own history,” he said. Source: BioEdge,

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Doctors “fire” patients for refusing vaccines

BioEdge, By Jared Yee: More and more American paediatricians are “firing” parents who refuse to vaccinate their children. Vaccine researchers say the practice appears to be growing, despite the fact that medical associations do not recommend it. A study last year showed that 30% of 133 Connecticut paediatricians said they had asked a family to leave their practice for refusing vaccines, and a recent study of 909 Midwestern doctors found that 21% reported dismissing families. In 2001 and 2006 only 6% of doctors said they “routinely” discharged families due to parents’ continued vaccine refusal and only 16% “sometimes” dismissed them. “There's more noise among paediatricians, more people willing to argue that it's OK to do this versus 10 years ago,” said Douglas Diekema, of the University of Washington in Seattle. Dr Diekema wrote the AAP’s policy on dealing with vaccine refusers, which recommends doctors address the issue at repeated visits, but lets parents have their way if the child is at no significant risk. Most paediatricians consider preventing disease by vaccination one of their primary duties. Source: BioEdge, Image: flickr.com

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The danger of being a doctor in a war zone

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Bioedge, By Jared Yee: Dr Abd-al-Razzaq Jbeiro, secretary-general of the Syrian Arab Red Crescent, was shot and killed two weeks ago on a highway near Damascus. Although the Red Crescent emblem was clearly visible on his vehicle. Dr Jbeiro’s death shocked the organisation, as well as the International Committee of the Red Cross (ICRC) and the International Federation of Red Cross and Red Crescent Societies. They have pleaded with those involved in the violence to spare Red Crescent and Red Cross staff and volunteers so they can perform their humanitarian work. The ICRC wrote in a press release: “The exclusively humanitarian aim of the Red Crescent and Red Cross is to bring aid in a fully impartial and neutral manner to people in need.” Dr Jbeiro’s death is only one example of violence against humanitarian healthcare workers. Médecins Sans Frontières (MSF) recently declared that its workers in conflict zones have increasingly found themselves and their clinics under attack. NPR reported two weeks ago that the organisation decided to stop treating patients from detention centres in Misrata, Libya because: “torture was so rampant that some detainees were brought for care only to make them fit for further interrogation.” It was noted in the Hastings Center Bioethics Forum that over 1800 people have been injured or killed in over 600 cases of violent attacks on healthcare professionals, clinics, patients or patients’ families across 16 countries in under 3 years – but that these numbers are “clearly not comprehensive”. It was also reported that the World Health Organisation’s (WHO’s) executive board passed a resolution last month calling the WHO director general for leadership in documenting such attacks. ~ Hastings Center Bioethics Forum, Feb 3; NPR, Jan 26; International Committee of the Red Cross, Jan 25The, Source: Bioedge, Image: flickr.com

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Doctor crowned Mrs Chennai 2011

Nithya Prasanna, a doctor, was crowned Kiah Mrs Chennai 2011 by actor Prashanth at a colourful event at Kamarajar Arangam on Tuesday. Preethi Venugopal, a corporate lawyer, and Gul Afshan Baig, an executive assistant at an MNC, secured the two other places respectively. Organised by Virgo, the 12th edition of the annual beauty pageant sought  to  recognise  and  honour  women  who excel led on both the family and work fronts. In all, 12 women were selected for the final stage from over 500 people who attended various rounds that assessed their qualities. The evening had three rounds assessing their communication skills in Tamil, dancing skills and their presence of mind. Audiences had a gala time, as non-native speakers tried their level best to communicate in the language. And the dance recitals deserve a special mention, as many of them, though first timers, performed on par with professionals. A panel of six judges — Neeti Jayachander (regional editor of Femina), Aruna Viswanath, Dr Priya Selvaraj, Singar Sriram, TV actor Mohanram, musician-turned-comedian Madhan Bob – appraised the participants. There were other subtitles that were won by Vijanthi (Communication Queen), Ruth Jennifer (Talent Queen), Suma Iyengar (Samayal Rani), Akshyalakshmi (Smart Queen), Nithya (Elegant Queen) and Jayalakshmi (Designer Queen). Entrepreneur Saundarya Rajesh was awarded Honourary Mrs Chennai 2011. Between the rounds, singer Pramod Nair of Satrangi music troupe performed to entertain the audience. Source: The New Indian Express

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China sets guidelines for doctors

News Leaks: Medical ethics and doctor-patient relationship guidelines have been written into a draft meant to systematize medical practitioners’ performances, China’s health ministry said. The draft was posted on the ministry’s website Monday to solicit responses and views from society as well as professionals in the medical industry. According to the draft, practitioners in all types of medical institutions should follow the proposed standards, such as respecting patients, observing medical ethics, enhancing communication with patients and not illegally accepting money or gifts offered by patients. Xinhua said medical workers’ performances will be evaluated in accordance with the conduct standards and those who break the rules will be punished. Authorities said the conduct standards are of great importance as some of the current laws only mention prohibited actions without providing positive educational guidance or covering medical problems that have arisen recently. According to the health ministry, a total of 14,976 cases of medical disputes were handled by the country’s emerging third-party mediation organizations, and over 80 percent of these cases have been settled. Source: News Leaks, Image: flickr.com

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Babies remember objects out of sight

It was earlier believed that babies six-month-old or younger have no sense of ‘object permanence’ – that something exists even when it is out of sight. But now psychologists know that is not true. For young babies, out of sight doesn’t automatically mean out of mind, the journal Psychological Science reports. But how much do babies remember about the world around them and what details do their brains need to absorb in order to help them keep track of those things? A study led by a Johns Hopkins psychologist and child development expert has added a few pieces to this puzzle, according to a statement. “What information do infants need to remember about an object in order to remember that it still exists once it is out of their view. The answer is, very little,” said Melissa Kibbe. Kibbe, a post-doctoral psychology researcher at the Krieger School of Arts and Sciences at Johns Hopkins, co-authored the study with Alan Leslie of Rutgers University. The team found that even though infants cannot remember the shapes of two hidden objects, they are surprised when those objects disappear completely. The conclusion? Infants do, indeed, remember an object’s existence without remembering what that object is. This is important, Kibbe explained, because it sheds light on the brain mechanisms that support memory in infancy and beyond. “Our results seem to indicate that the brain has a set of ‘pointers’ that it uses to pick out the things in the world that we need to keep track of,” she explained. Source: News Leaks, Image: flickr.com

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Brazilian gives birth to two-headed boy

The Asian Age: A Brazilian women has given birth to a baby with two perfectly formed heads and doctors say the new-born appears to be in good health. The baby weighing 9.9 pounds was delivered by emergency Cesarean section early Monday in a hospital in Anajas in the northeastern Para State. Following the birth the baby, his  mother  Maria  de  Nazare admitted   that  she   had   been   told  she  was  set  to  welcome  twins.  But

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Screern Shot On Linked Video

following a number of tests, doctors found that the baby has two brains and two spines but shares one heart, lungs, liver and pelvis, the Daily Mail reported. According to doctors, the two-headed boy, in reality, is conjoined twins who share a single body. The condition is known as dicephalic parapagus — an extremely unusual form of conjoinment. As they share the same body, it is not possible to separate dicephalic parapagus twins, they said. Claudionor Assis de Vasconcelos, director of the hospital where the baby was born, told Brazil’s O Povo newspaper that the baby’s mother, Maria de Nazare, decided to travel to the hospital after she felt strong abdominal pains. The 25-year-old mother, who lives in a rural area of the state, had no ultra-sound scans during her pregnancy and only found out about the abnormality minutes before the baby was born, De Vasconcelos said. “When doctors scanned her they realised that the baby had two heads and that a normal birth would be a great risk both for mother and baby. The caesarean took an hour because the baby was sitting down,” he said. Source: The Asian Age

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