Medical Ethics and Emerging Media

Patients expect doctors to be trustworthy. They trust us with their lives, privacy, and information. When doctors use electronic medical records, EMR, the patients worry that they will be available to anyone who has a computer. The doctors and other healthcare providers must follow medical ethics. All doctors who belong to the AMA, American Medical Association must adhere to the “Principles of Medical Ethics” found at www.ama.org. Doctors must ensure privacy of EMR and only disclose what the patient requests.

 

Doctors share information ethically. When patients want a physicians or healthcare providers to share information, they must make the request in writing in which identifying information is given. It is unethical to share information without permission. The new HIPAA Laws, Heath Information Portability and Accountability Act, require patient permission to permit health information disclosure as explained in http://www.hhs.gov.ocr/hipaa.

 

Most physicians will discuss a patient’s health status if someone accompanies a patient to the office visit. That is implied consent. Many wives accompany husbands to the doctor’s office to help take care of the patient with medication and treatment instructions. HIPAA has guides to what a healthcare practitioner can ethically disclose. The HIPAA Privacy Rule is (PDF – 372KB). The United States Department of Health and Human Services provides educational materials to patients concerning privacy of medical records. A patient can download a file and conveniently carry it on a disc, www.b2b-exchange.com.

 

When patients have a complex medical history with diabetes, hypertension, or Atherosclerotic Heard Disease, ASHD, the patients can transport all of their records on discs. The physician who accepts these patients, will easily download the medical information. Since the patient has the disc, the patient is in control of health care information and who can read it, according to www.BuyerZone.com. The patient chooses who reads medical information. See podcast discussion with Mary Whitt, Senior Management Consultant. (Source: SoundPractice.net)

Emerging Media and Emergency Care

For 50 years Dr. Madden provided emergency care to the citizens of Wolf County. He practiced by himself, delivered babies, and applied casts. Though he took his own X-Rays, sometimes he needed an expert opinion. The patient and the X-Ray would travel by ambulance to another county, since there were no hospitals in rural Wolf County when a patient needed care he could not provide. An addition of a Web camera to his computer would connect him to the University of Kentucky, www.uky.edu and www.mc.uky.edu/medicine, for consultation. The patient profile and X-Rays can be viewed by a university expert, www.UK.edu electronically who can assist in a difficult case.

 

Kentucky and West Virginia have exciting wilderness areas. People from all over the country come to Mingo County to ride the Hatfield McCoy Trail on trail bikes and 4 wheelers. They ride rafts down the New River, ski at Snowshoe, and hike the Red River Gorge in Kentucky. Injured vacationers might stretch the local Emergency Medical service. They might seek information form Wilderness and travel Medicine, www.wilderness-medicine.com.

 

For those who do not carry pick and snowshoes up Denali or trek in Nepal, there are short films to view. The best of Telluride’s Mountainfilm Festival will inspire audiences with cross cultural experiences dedicated to inspire and educate audiences, www.mountainfilm.com. The Mountain Film on Tour captures the excitement of wilderness travel and medical hazards of extreme sports. 

 

Rural physicians, ski resorts, white water raft companies, and expeditions find injured travelers miles from help without the means of rescue. The American College of Emergency Physicians, www.acep.org, recommends Wilderness CPR and First Aid to team leaders. They offer Injury Prevention guides at www.emergencycareforyou.org.

Short films and Web sites will help train wilderness guides and help them with emergency care.                                                   

 

 

 

 

 

Web Sites and Infomercials Help Disabled

 

When patients have hearing defects, they benefit from assistive devices such as hearing aids and ear phones. These ads appear to be written and produced by healthcare providers instead of marketers. There must be a balance of information and marketing in these infomercials.

 

From Digital Hearing aids, the patients can order online and hear the difference provided by amplification. A visit to www.naturear.com, gives the visitor audio enhancement. The hearing aids are made to fit and now have a 2 for one sale. The Web site looks like a medical site instead of a product site. Form fitted hearing aids can be found at Hearpods, www.hearpods.com.

 

Visually handicapped people benefit from short films and audio commercials. These infomercials give information about sight aids and an opportunity to sell them. At www.1-glassesstore.com, the visually impaired can see how glasses enhance vision. Also doctors and dentists can purchase Stereoscopic 3-D glasses to distract patients as dental work and other procedures are performed on patients.

Women who have served as waitresses develop bunions and feet pain from years of standing on their feet. Nurses develop Achilles tendonitis from years of patient care and  walking on hard hospital floors. Proper foot care will provide less foot pain and increased comfort. FootSmart, www.footsmart.com, is a company that sells products to enhance lower body function and comfortable foot products. A visit to the Web site is informative. There are products to improve muscle tone, reduce strain, and enhance comfort. There is a balance of information and marketing.

Menopause disables many women. To treat newly menopausal women, a pharmaceutical company, Wyeth Labs, developed a Women’s Health Department that dealt with menopause. Their scientists produced estrogen replacement products in the form of Primpro and Premarin. At www.wyeth.com, patients can listen to testimonials and infomercials concerning women’s health products. They will have access to pharmacists and scientists through e-mail and FAQ’s.

Medicine and Ethical Disaster Management

The federal government spent billions of dollars preparing the country for terrorism and disasters. The Center for disease Control requested that physicians stockpile medications such as Cipro and other antibiotics. They trained ministers and social workers to provide disaster counseling and emergency workers to contain the situation. Healthcare workers want disaster training to become part of nursing and medical school curriculum. On the other hand, some see disaster courses as an unethical way to gain a profit.

The Emergency Medicine Learning and Resource Center at www.emlrc.com presents the 2009 International Disaster  Management Conference to be held February 19-22, 2009 at The Rosen Centre Hotel in Orlando, Florida, www.rosencentre.com. All people involved in emergency preparation, management, and response will benefit from this course. Doctors, nurses, EMS, and mass fatality responders will be “preparing freedom’s Lifeline,” by taking a course like this one.

 

After receiving a three year grant, The West Virginia  Department of Health and Human Resources, www.wvdhhr.org, trained community responders throughout the state. At locations such as The Earl Ray Tomblin Center in Logan it trained nurses, doctors, ministers, and social workers to teach the course, The Psychological Impact of Disaster and Terrorism. It was an outstanding course, and it offered continuing education credits that these professionals require for their licenses. Many took the course for the credits, and less than 10% taught the course after becoming certified as a Trained Community Responder, TCR.

 

Mental Health is affected by disasters such as Hurricanes Hugo, Andrew, and Rita, floods and fires. Ethical as well as unethical people arrive to provide services. All must be properly credentialed to provide counseling. There ar  e numerous disaster mental health Web sites to verify credentials such as www.aaets.org, American Academy of Experts in Traumatic stress, www.aamfi, Association of Marriage and Family Therapists, www.redcross.org, American Red Cross, www.fema.org, Federal Emergency Management Agency, and www.disasterpsych.org, Disaster Psychiatry Outreach.

 

Doctors, nurses, paramedics, and EMS train for disasters in Basic Disaster Life Support Classes. The first class in West Virginia was offered in Morgantown August 8-10, 2008. Emergency room physicians from West Virginia Hospitals and personnel from Pittsburg produced the course with hopes of WVU becoming a training site, www.wvu.edu. Trainers must be ethical, and courses must follow medical ethics.

Medical Web Sites and Breast Cancer

October is Breast Cancer Awareness month. One out of eight women will suffer from breast cancer. The Amercian Cancer Society and many organizations provide information and support form Web sites.

From the Web site of www.cancercure.org comes a creative outreach that understands its target audience, women. It uses pink and other pastel colors to give it a soft look. A calendar lists events such as telephone education workshops and prevention tips. There are lists of Pink Ribbon products. During October, The company From You Flowers will donate 10% of its profits. Support groups are offered to victims of breast cancer.The Web site is informative, easy to navigate, and appeals to women.

During October, many Public Health Clinics have Breast Awareness Programs and Clinics. On the Web page for the Center for Disease Control, www.cdc.gov, is a photograph of two women with overlying graphics, “Breast Cancer.” It has numerous articles and suggestions for the prevention of breast cancer and its treatment. A yearly mammogram is recommended for all women over fifty. Self breast exam is taught and encouraged. Trained oncology social workers will help telephonically or electronically.

The West Virginia State Medical Association’s Web site, www.wvsma.org, is black and white, common to medical web sites. It is easy to navigate and find useful information. It celebrates October Breast Cancer Month and lists clinics for free breast exams and mammograms. Though the Web site targets West Virginia physicians, any visitor will find it easy to navigate. It porvides useful links for non-physicians such as breast health.

An outstanding Web site is www.cancer.org, the Ameican Cancer Society. The red, whte, and blue logo is on each page, and the colors are carried to each page giving it a consistent look. The 1-800-ACS-2345 is listed atop the page indicating a desire to help cancer victims. There are support programs, lists of where to go for care and treatment, and a “Find It fast” menu. It lists programs that celebrate Breast Awareness Month. The Web site is engaging, colorful, helpful, and easy to navigate.

Creative Medical Web Sites

Most medical Web sites lack luster, yet they teem with information. From a medical clinic or hospital come needs to educate patients about side effects of medications or a procedure. Accessing a pharmaceutical Web site will yield patient information packets and articles. A medical association will map out its goals.

A visit to www.wyeth.com takes the physician to the Web site of Wyeth, one of the largest pharmaceutical companies in the world. The first step is to log in. Before becoming familiar with the web site, the visitor must log in which then provides access to patient information, articles, and access to product information. Once logged in, the visitor will find 3000 pages of a Medical Encyclopedia, thousands of articles and studies, and hundreds of pages to download to give to patients about products such as Primpro and vaccines. A log in is the first step which might deter visitors from this Web site filled with information.

In preparation for a conference on the treatment of vaccine preventable diseases, a physician visited www.cdc.gov, the Web site for the government agency, the Center for Disease Control. The colors are blue and white. In very small print is a list of publications, tools, and resources. A click on “CDC health Protection Goal will provide the visitor with information relevent to vaccines and diseases. Because a large amount of information is on the Web page, the print is small, and the site is cluttered. However, it gives a lot of information and is easy to use.

When a Public Health Physician physicians want to become advacates of preventable diseases, they can join The American Public Health Association at www.aphaorg. The Web site is blue and white, common to medical Web sites, with a list of useful links such as how to join, advocacy, and meetings. though lack luster, it is easy to navigate, join, and become a member of a caring organization. This Web site is like a map. It uses space created by the flow and movement of relational networks.

One of the largest medical Web sites is www.ama.org. The American Medial Association is the largest medical organization in the world. It archives articles from over a hundre years of publication. Though it suffers from information overload, it is easy to find article, how to join, and how to be an advaocate for medicine. It appeals to the intellect of its target audience, physicians.

Medical Concerns about Advertising to Children

The American Medical Association and the American Academy of Pediatrics report that children eat an excess of unhealthy food. Advertising to children helps create needs and wants in children that results in overeating foods high in sugar and fat. Parents need to chose healthy food for children and help them develop a healthy lifestyle. Harvard psychologist Susan Linn explains why she opposes marketing to children at http://marketplace.publicradio.org/shows/2005/01/27/PM200501274.html.

At http://www.2.kelloggs.com with a click on the “family focus” link will find offers of free movies and examples of spokes persons recognized by children. Tony the Tiger wants to change his stripes. Barbie (from Mattel) and Hot Wheels help children chose Sugar Frosted Flakes. Indiana Jones helps sell Rice Krispies and when children see Indiana Jones, they will associcate him with Rice Crispies. Children can play video games at www.fruitloops.millberry.com. These Web istes impress the brand on the children’s minds as they watch and play branded video games that make them want sugared products.

     Teachers report that children are more violent thanks to violent video games. Physicians warn parents to monitor the amount of time their children spend on Web sites with games that encourage violence. Pediatricians and Public Health physicians report that 25% of all children are over weight due in part from eating too much sugared snacks. The sole purpose of video games on food web sites is to capture the childrens attention so that they will peater their parents to buy them. At www.hershey.com, a child can play cyberfootball with Hershey Kisses. Then they crave a Hershey Chocolate Bar. Marketing to children makes them crave sugared snacks.

Physicians feel that children are overwhelmed with information and advertising. Neary explains that children over age 15 look at adult Television and sort through the sex and violence without parenteral guidance at http://www.npr.org/templates/story.story.php?storyID=5595146ft=1. They hear over 3000 messages everyday, and it is difficult to sort through the clutter. Physicians, teachers, and parents must help instill values in children so that they do not fall prey to advertisers who promote an unhealthy life style. The American Academy of Pediatrics wants to limit children to no more than 2 hours of television and computer every night.

Medical Websites Targeting Minorities

Because diseases vary by race, geography, and gender, medical Web sites offer advice to minorities and different populations.

African Americans develop Diabetes Mellitus, also known as “Sugar,” at a higher rate than the population at large. An effective medication for diabetes is Glucotrol XL, an extended release tablet made by Pfizer. Their Web site, www.pfizer.com, has additional information on how to treat and control Diabetes Mellitus. A complication of Diabetes is erectile dysfunctions, and information about the treatment can be found at www.viagra.com. The ads show effective treatment of African American men who suffer from Diabetes and Erectile dysfunction.

Hispanics develop hypertension, also known as high blood pressure, at a rate higher than the general public. A visit to www.merck.com will have information in Spanish. One of their most effecitve products is Zetia 10 mg. A discussion of life style changes is in order. Food and weight management are very important. A visit to www.kraft.com will give recipes and food information in the Hispanic section for Hispanics who need to count calries and make healthy food choices. There are recipes for chiles rellenos, sopas, and traditional food.

For imigrants who might not understand their medications, the drug company chain, Walgreen’s is able to print the medication lablel in 14 languages. At www.walgreens.com, the non-English speaking minority patient can have a prescription printed so that he/ she can understand the medication prescribed, what it is for, and how to take it.

The White male patient has a greater chance of bad knees than any other group. Many men ruin their knees in basketball, football, or industry. The schering Corporation targets the middle aged white male at www.schering.com. It promotes the injectible Celestone to reduce inflammation and provide long lasting releif. It has been used for over 40 years in treating patients with bad knees.