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"The AHA should encourage objective evaluation of innovative approaches to
treatment-particularly those that involve new technologies, before they gain
widespread acceptance.
In the emotionally charged atmosphere of medical care,
the momentum of a new technology too often puts the burden of proof on those who
question the evidence for it, rather than on those who propose it. The result is
that the technology quickly becomes the accepted thing to do [and] further attempts
to test it are subject to the charge of being unethical.... [6] AED manufacturers
will keep the AED option in the forefront of discussions about delayed in-hospital
defibrillation; as a public service organization, the AHA should actively encourage
consideration of a broad range of alternatives. There may be ways to achieve the
goal of rapid in-hospital defibrillation less expensively--and much sooner--than by
making progress contingent on the successful marketing of AEDs to hospitals."Oops-I accidentally posted the previous post prematurely. It's a response to Garrick
from something I wrote in 1996: Stewart JA. Delayed in-hospital defibrillation.
Annals of Emergency Medicine 1996; 27(1): 5-6. The paragraph with the [6] reference
is from a Brookings Institute publication."The paragraph with the [6] reference
describes an inverted ethical attitude toward more testing. It would seem more
testing could be a threat, and that the defense mechanism is to reverse the
perception of who is unethical by calling the charge to test unethical, rather than
the unwillingness to test as unethical. There are two possibilities, 1) that the
device is considered ""good enough"" and testing will delay widespread deployment,
or 2) further testing will delay profits.""I thought there was a reply from
Marshall Allen asking what ""simple, cost effective remedy I"" I advocate. I can't
see the reply now, but I would like to respond. An answer to the question can be
found at The link leads to my open-access
article. I'll point out that after all the editing and proofreading, a clause was
omitted. After the colon in the first paragraph of the Discussion section, there
should have appeared ""clinicians trained and authorized to use the defibrillators
were typically intensive-care physicians and nurses who were often far from the
scene of the arrest."""Listen inInteresting article and interesting comments after
the article - pertains more to opinions about how to improve safety and quality
than the Presidential candidates.Interesting comparison to the airline industry. I
think I actually agree with Dr. Johnson on this."On the topic of patients reporting
adverse events there was another item published today, this one sort of on the
skeptical side."
"Wow, this is a really good article. this is one of the best things I have seen
written in a long time"Who sent the information about ALEC with the information
about a state legislator who went to the strip club. If you sent that can you put
it out again for me."In recent years research has confirmed that a high
proportionof unnecessary surgery is still being performed, even by reputable
surgeons. This practice needs to be considered in its social perspective.If a nonsurgeon were to cut someone open with a knife, remove a perfectly healthy organ and
simultaneously rob the same person of $1,ooo, he would be charged with assault with
a deadly weapon, attempted murder, robbery, and numerous other offences. If he said
in his defence that he did it for the victim's own good, a jury could justifiably
find him criminally insane.On the other hand, this same procedure ceases to be a
crime when performed by a suitably qualified medical practitioner, who has judged
in his professional opinion the operation is required or 'indicated'.Many surgical
procedures still have no demonstrated proof of their effectiveness or of their
value to the patient.""Good analogy June.. This is the exact same thing I told the
police in regard to what my former doctor did to me. They told me if what happened
to me at Mercy Hospital had happened in an alley somewhere, they could file
charges. They said that when a doctor is involved, it's considered 'civil'.
Outrageous!""After I was butchered, I felt as though a criminal held a gun to my
head, took me down a dark alley, knocked me unconsious, mutilated 6 healthy organs
from my body, sewed me up and left me to fend for myself. So when I found a book
titled ""Bad Medicine: Is the health care system letting you down."" and read what