To the Editor:
Re “Ethical Dilemmas in Medical Care” (Opinion visitor essay, Might 8):
It’s unsettling, and dismaying, to learn Dr. Carl Elliott’s account of ethical lapses persevering with to exist, if not thrive, in medical schooling. As a neurology resident within the early Nineteen Seventies, I used to be assigned a affected person who was scheduled to have psychosurgery.
He was a prisoner who had murdered a nurse in a hospital basement, and the surgical procedure to take away a part of his mind was thought-about by the division to be a therapeutic and even forward-looking process. This was regardless of its being broadly discredited, and involving a prisoner who couldn’t present actually knowledgeable consent.
A fellow resident and I knew that refusing would nearly actually end in suspension or dismissal from the residency, so we anonymously contacted our native newspapers, whose reporting resulted in an overflow protest assembly, cancellation of the psychosurgery and legislative motion inserting situations on the acceptance of knowledgeable consent by prisoners.
It’s lamentable that though bioethics applications are broadly included into medical schooling, ethical and moral transgressions stay a cussed downside as a part of medical constructions’ groupthink.
As Richard Feynman has emphasised, doubt, uncertainty and continued questioning are the hallmarks of scientific endeavor. They should be an integral component of medical schooling to raised put together younger docs for the inevitable ethical challenges that lie forward.
Robert Hausner
Mill Valley, Calif.
To the Editor:
I want to thank Carl Elliott for exposing the “Ethical Dilemmas in Medical Care.” There’s a medical college tradition that favors docs as privileged individuals over sufferers.
I can keep in mind a number of affected person interactions in medical college through which I thanked a affected person for permitting me to look at them and apologized for hurting them throughout my examination of their painful situations.
I used to be then criticized by attending physicians for apologizing to the sufferers. I used to be advised, on a number of events, that the affected person needs to be thanking me for the privilege of aiding in my schooling.
Medical coaching, in a medical college tradition that favors the privilege of the medical workers over the rights and emotions of sufferers, must be uncovered and adjusted.
Doug Pasto-Crosby
Nashville
The author is a retired emergency room doctor.
To the Editor:
As a psychiatrist and medical ethicist, I commend Dr. Carl Elliott for calling consideration to a number of egregious violations of medical ethics, together with failure to acquire the affected person’s knowledgeable consent. Dr. Elliott may have included a dialogue of physician-assisted suicide and the slippery slope of eligibility for this process, as my colleagues and I not too long ago mentioned in Psychiatric Instances.
For instance, as reported in The Journal of Consuming Problems, three sufferers with the consuming dysfunction anorexia nervosa have been prescribed deadly treatment underneath Colorado’s Finish-of-Life Choices Act. Due to the near-delusional cognitive distortions current in extreme anorexia nervosa, this can be very uncertain that sufferers may give actually knowledgeable consent to physician-assisted suicide. Worse nonetheless, underneath Colorado regulation, such sufferers should not required to avail themselves of accepted remedies for anorexia nervosa earlier than prescription of the deadly medicine.
Tragically, what Dr. Elliott calls “the tradition of medication” has change into more and more desensitized to physician-assisted suicide, these days touted as simply one other type of medical care. Within the anorexia instances cited, knowledgeable consent could have been one casualty of this cultural shift.
Ronald W. Pies
Lexington, Mass.
The author is on the college of SUNY Upstate Medical College and Tufts College College of Medication, however the views expressed are his personal.
To the Editor:
Carl Elliot’s article on medical ethics was glorious. However it isn’t simply within the medical occupation that there exists the “refined hazard” that assimilation into a company will train you to not acknowledge what’s horrible.
Companies too have a tradition that may “rework your sensibility.” In lots of industries executives test their consciences on the workplace door every morning. For instance, they promote cigarettes; they overlook they too breathe the air as they foyer towards clean-air insurance policies; they overlook they too have youngsters or grandchildren as they struggle climate-friendly insurance policies or resist gun-control measures. The checklist may go on.
In each group, we want people to say no to insurance policies and actions which will profit the group however are dangerous, even damaging, to broader society.
Colin Day
Ann Arbor, Mich.
Don’t Cave, Columbia
To the Editor:
Re “Columbia’s Protests Additionally Convey Strain From a Personal Donor” (entrance web page, Might 11):
Universities are supposed to be establishments of upper studying, analysis and repair to the neighborhood. They don’t seem to be gadgets on an public sale block to be offered to the very best bidder.
Universities that dump their coverage platform to spoiled one-issue donors who threaten to throw a tantrum not deserve our respect. Grant-making foundations shouldn’t be grandstanding on-line. Give cash, or don’t, however don’t name a information convention about it.
If Columbia caves, why ought to potential college students belief it as a spot the place they’ll go to change into freethinkers and discover their very own political conscience as they start to ponder the broader world and problems with social justice?
This can be a actual take a look at of Columbia and its management. I don’t envy its president, Nemat Shafik, who has few good decisions and no technique to make everybody pleased. What she shouldn’t promote is her integrity, or the college’s. She ought to stand as much as these egocentric donors. Study to say, “Thanks, however no thanks.”
Carl Henn
Marathon, Texas
A Florida E book Oasis
To the Editor:
Re “E book Bans? So Open a Bookstore” (Arts, Might 13):
Deep respect for the American novelist Lauren Groff and her husband, Clay Kallman, for opening the Lynx, their new bookstore in Gainesville, Fla. The shop focuses on providing titles among the many greater than 5,100 books that have been banned in Florida faculties from July 2021 via December 2023.
To all of the e book clubbers and haters of bans: Order straight from the Lynx.
Battle evil. Learn books.
Ted Gallagher
New York
To the Editor:
Re “Preserve a Agency Grip on These Mickey Mouse Balloons. It’s the Regulation” (entrance web page, Might 9):
Balloons are a number of the deadliest ocean trash for wildlife, as talked about in your article about Florida’s anticipated balloon launch ban.
Plastic balloon particles poses a major risk to marine life, typically mistaken for meals or turning into entangled in marine habitats, resulting in devastating penalties for our fragile ocean ecosystems.
Because the founding father of Clear Miami Seashore, an environmental conservation group, I’m involved in regards to the impression of plastic air pollution on Florida’s wildlife and coastal areas. Florida’s gorgeous seashores and numerous marine life should not solely treasures to us locals but additionally draw tens of millions of vacationers every year.
Due to the hazards, intentional balloon releases have been banned in lots of cities and counties throughout the state. A ballot launched by Oceana confirmed that 87 p.c of Florida voters assist native, state and nationwide insurance policies that scale back single-use plastic. Gov. Ron DeSantis should waste no time in signing this essential piece of laws into regulation.
Our elected officers ought to proceed to work collectively to handle environmental points so Floridians and vacationers can take pleasure in our stunning state with out its being marred by plastic air pollution.
Sophie Ringel
Miami Seashore
