Medicine & Medical Practices
All primary medical studies conducted in humans, with either public and/or private monies, must be published within a maximum of 12 months after their conclusion, unless the study organizers have a compelling reason (determined by the courts) to continue to keep the results secret, such as to secure patents. These studies would include basic research, clinical research and epidemiological studies. Currently, it is all too common for only those studies favorable toward a drug or procedure to be published while other inconclusive studies or negative studies are withheld. This status quo leads to a very significant misleading of both the public and scientific community in regards to the effectiveness of many medicines and medical practices. Naturally, biases in this type of information lead to unnecessary and very significant increases in human sufferings and death and/or lead to significant reductions in the rate of improved human health. Such biases also lead to gigantic wastes of resources due to duplication of studies and misguided studies.
An unbiased third party should be the agency that designs and conducts medical research trials so that inherent conflict of interests of companies testing their own drugs could be avoided. A representative industry congress could be the entity that operates this organization. Perhaps the best thing would be to create an integrated database based on some kind of standard that would be able to more easily allow the necessary information to be captured in a standardized way so as to measure multiple variables. One way would be to institute a comprehensive health statistics database into which all patient data would be loaded.
Secondary research studies mainly involve a study of previous research data, and it would be very beneficial for all such studies of this nature to be mandated to be made public as well.
All trial funding sources must be made publicly available within 12 months of the conclusion of any trial.
Perhaps the government or an industry congress could mandate that the industry decide on one medium/publication (such as a website) devoted to publishing such studies. Such a website should be designed so as to allow researchers and the public to easily find all studies concerning a drug or medical procedure.
In fact, all scientific research, regardless of discipline, conducted, at least in part, with public monies should be published within a maximum of 5 years of completion, unless national security is an issue. With the exception of medical research which should always be published, all other privately funded research should be encouraged to be published.
Understandably, private research will often generate information that could clearly be kept confidential without any potential of public harm. Examples include company mining data, recipe formulas such as for Coca-Cola or KFC chicken, etc. These are decisions that could be made on a case by case basis and which an industry congress could adjudicate.
The main idea of this proposal is to release to the public, in a timely manner, basic research information about the world, especially in relation to human health, so that everyone would have access to it and build upon it to continue learning about how the world works. To allow such data to be essentially forgotten by not being made readily available to the scientific and public communities, contributes to the delayed and inefficient advance of scientific progress due to the increased duplication of efforts, misdirected resources, a smaller base of established fact and loss of potential due to the compounding time-value quality of scientific discoveries.0 Comments
As a general rule, vaccinations should be strongly recommended for the entire population except, obviously, for those for whom it may pose a risk deemed to be too high (either due to possible allergic reactions to the vaccine or some other reason).
However, vaccines should be used as sparingly as possible (to minimize the risk of vaccine-induced diseases), yet liberal enough to ensure a population effectively immunized against a significant outbreak of serious disease. Ideally, the best balance would be to vaccinate the population until the number of people acquiring the disease from the natural environment begins to drop below the number of people acquiring the disease (unintentionally) through the vaccine or acquiring some other significant vaccine-induced complication.
If parents so choose, vaccines could be given separately in individual doses to allow the body to adjust completely before the next dose is administered. However, because there is no evidence to suggest that this is in any way beneficial in comparison with simultaneous vaccinations with multiple vaccines, parents should be informed of the additional costs involved in such a choice, namely additional doctor visits, travel time, etc.
Vaccinations should be voluntary but people refusing to permit vaccinations for themselves or their children should be required to pay a fee that varies according to the percentage of the total population who have refused vaccinations. The higher the percentage of people who are not vaccinated, the higher the fee will be. For example, if 10% of the population is not vaccinated against measles, parents who refuse to have their child vaccinated against this disease should be required to pay a fee of $100 per year for every year in which the child remains unvaccinated beginning with the year the vaccination is first normally scheduled to be administered. In addition, parents and children may face some social restrictions such as not being allowed to attend school if a measles outbreak is occurring. If 20% of the population is not vaccinated, then the fee may rise to $200 per year, thus encouraging more people to choose to get vaccinated. However, the fees for refusing vaccinations should be based on the actual relative risks posed to the population by the specific characteristics of the disease (some diseases are more inconvenient and deadly than others), the ease with which the disease is communicated, the risk of complications, and the average cost of treating such illnesses.
Universal vaccinations prescribed by the governing public health agency should all be free. Because the public benefit is so high from a properly vaccinated population, and because there is no significant risk of any real waste of vaccines (most people wouldn’t needlessly seek out additional doses of the same vaccine), keeping the vaccines free would eliminate the excuse that the poorest people may have for not being properly vaccinated. It would also simplify the whole administrative process.
Immune shots and other types of shots that leave, or have a likely chance of leaving permanent, significant scars on the body should not be administered on a very visible place of the body, such as on the upper outside portion of the arm (on the deltoid muscle), for example. Another, more hidden portion of the body should be sought so that the recipient does not have to endure unsightly scars in such an obvious location.0 Comments
All antibiotic drugs and products should only be obtained through a doctor’s prescription. Drugs/antibiotics should not be routinely prescribed for people with or without illnesses if they will benefit only minimally and/or if it will result in a significant threat to the general population in the future due to mutations of more resistant forms of bacteria.
Doctor’s should be required to justify, in writing, their prescriptions of antibiotics and should periodically notify the American Medical Association and/or other medically oriented organizations of the number of prescriptions granted for purposes of statistical analysis.
The sale and distribution of antibacterial products should be banned. These should only be available by prescription from a medical professional and only for the purpose of protecting those with demonstrated immune deficiencies or who have been diagnosed with any other valid condition to demand such products.
Antibiotic Usage In Food Animal Production
Antibiotic usage in food animal production should be minimized to the greatest degree practical so as to reduce the future evolution of antibiotic resistant of bacteria in both animals and humans. All non-therapeutic (i.e., not used to treat diseases) uses of antibiotics should be either banned or taxed at extremely high rates, such as $1 per pound of animal treated throughout its lifetime. Such a high tax would reduce the prevalence of usage to a degree which would not pose dramatic negative health consequences in the future. Enforcement and stiff penalties, as is the case with any law, are absolutely essential. All animal uses of antibiotics, for whatever reason, needs to be reported to the proper authority, such as the FDA.
Therapeutic uses should be minimized and the most effective way to do so is to ensure that animals have a healthy, spacious, sanitary environment in which to live and grow during all stages of their lives. The natural immune system of animals should protect them if conditions are proper. Antibiotics should be used sparingly and only on a case by case basis. The only way to ensure such conditions is by surprise inspection of production facilities and stiff fines for non-compliance. Perhaps operations beyond a certain size should be required to provide periodic public access, perhaps with tour guides provided either by the company itself, government regulators or other knowledgeable people. Even school field trips would be an effective restraint against cruel living conditions.0 Comments
Hospice care should be the default form of care for patients who are effectively bed-ridden, have terminal prognosis and who are older than the current life expectancy at birth plus 5 years. If the family of a patient requests that curative treatments continue, the medical team will assess the prospects for recovery and, in consultation with the family, decide whether such treatments are warranted. If it is determined that additional curative treatments are not warranted, but the family insists that they be continued anyway, then they should be continued with the family picking up the bill for such treatments.
Hospice care should also be imposed on patients younger than the above threshold if they otherwise meet the same criteria and consistently express a wish to die. However, if the family insists on continued curative treatments against the medical team’s recommendations, then the family should only be required to pay half the cost of such treatments until the patient reaches the age of life expectancy at birth plus 5 years, at which point the family would be required to pay all costs associated with continued curative care.0 Comments
Hospitals are unnecessarily noisy places. Non urgent alarms and normally functioning medical equipment are especially needlessly noisy. All hospitals should strive to keep unnecessary noises completely out of patient recovery rooms. It is logical to assume, but it has also been shown that a quiet environment aids recovery. Not only that, but alarm fatigue (aka alert fatigue) is a very real precipitating factor in many critical mistakes often made in hospitals and other settings where too many non-essential alarms and data are being presented to personnel that they often become desensitized to them, leading to a delayed awareness of or outright missing of important information.
Hospital machinery placed long-term at a patient’s bedside should not make any noises, except when it detects something to be outside of a normal range. Hospital conversations between staff should take place at nursing stations rather than in hallways, when possible, squeaky wheels and doors should be fixed, establishing and respecting quiet hours in all inpatient areas, and providing earbuds or earplugs for all patients should should be just some of the measures taken to reduce the level of ambient noise in hospitals.0 Comments
Doctors, nurses, etc., who work in the medical profession, should be required to take periodic courses and learn how to identify the symptoms of biological or chemical attacks. When these medical personnel notice an unusual number of patients (maybe two standard deviations from normal) exhibiting these symptoms, they should immediately notify the federal government and give them all the statistics.
Hospitals and doctors should have the authority to quarantine patients without first obtaining a court order or any other kind of permission if, in their judgment, this action would be the most appropriate and safest thing to do, especially considering the importance of containing an epidemic or disease as soon as possible.0 Comments
Websites that describe and discuss, in great detail, the causes, symptoms, treatments, and effects for every possible type of human medical problem ought to be made available for everyone. Ideally, such a website should allow a person to click on any part of the human body (or within an exhaustive list of named body parts) and get information on absolutely every possible type of problem that has ever been known to be associated with that body part. The information should be complete enough that a person should be able to self diagnose their own problems with a fair degree of accuracy.0 Comments
To determine whether a person should be compensated for medical malpractice, a group/jury of maybe 30 doctors, specialists, or other people qualified to perform the type of procedure that the defending doctor is being accused of doing wrong, should be gathered together in a room and should be given and told all the information that the defendant doctor knew at the time. This jury of 30 doctors, specialists, etc., should vote and decide whether the doctor acted reasonably correctly or incorrectly according to the information available at the time. It may be appropriate to require different voting thresholds (i.e. majority vote, 2/3 majority, 3/5 majority, 4/5 majority, etc.) for different types of charges that many range from minor things to murder. If it is found that the doctor didn’t have all the information required or needed at the time, then any people responsible for that lack of information should be punished.
Human Health Index
People’s physical conditions should be graded on a 100-point scale where a grade of 100 would indicate practically perfect health on all physical aspects of the individual, and where a 0 would indicate a dead individual.
This would be a nice system to have as another measure of human health, but it could also be used to determine what type of punishment should be given to a doctor who committed medical malpractice. For example, a patient who, prior to surgery had a certain score, say 80, and after the surgery in which the doctor allegedly made a mistake, the patient’s score dropped to 30, this would provide a quantitative measure of the doctor’s errors.
Of course, to understand the significance of the doctor’s error, there must first be a history of patients with a similar initial condition and grade and similar operation. If the patient’s grade after the operation is very different from what would have been expected by a statistical analysis of similar cases, and also if a professional panel of experts agree that the results are significantly abnormal, then a proper punishment could begin to be formulated. However, the facts of the particular case would dominate any discussion of penalties against the doctors.
This system could be used to determine at least part of a doctor’s punishment. For example, if a patient with an initial condition of 30 undergoes an operation, then during or after which his condition changes to 0 (patient dies), the doctor or surgeon would not be punished as much as if a patient with an initial condition of 90 dropped down to 10 as a result of a similar operation. In other words, at least one factor in determining medical malpractice penalties would be how much the medical error changed the condition of the patient, and not just whether or not the error resulted in his death.
This same basic system could be used to help reduce hospital and medical facility errors such as misdiagnosis, wrong treatment/surgery, even new infections and injuries, etc., by charging the hospital, doctor, and other responsible entities a significant fine based on the degree of damage to the patient. This would encourage hospitals to take measures to reduce error rates. The actual amount of each fine would depend on the severity of the error as well as on the particular facts of each case, but perhaps a good rule of thumb should be a compensation package which includes the free delivery of all corrective actions necessary plus a punitive multiple equivalent to twice the amount it costs to both perform and correct the error. The minimum punitive multiple for any significant error could be set at $1,000.0 Comments
Human death should be defined as that point at which it has been determined that upper brain function is irretrievably lost.
The family and/or friends of people that remain in a coma continuously for more than one year should be given the option of either bearing the full costs of maintaining the person beyond 13 months or allowing that person to die. Insurance companies should not be required to continue funding individuals in comas for more than 13 months unless policyholders specifically ask for and pay for such an insurance policy.
The family and/or friends of patients who have been brain dead for 3 months should be required to either bear the full costs of maintaining the individual in a vegetative state beyond the 3-month limit or allow the person to die completely. Insurance companies should not be required to continue funding individuals in a brain dead state for more than 3 months unless policyholders specifically ask for and pay for such an insurance policy.0 Comments
No prohibition should exist against people donating or being compensated for selling at market rates blood, plasma, organs, or any other body parts that have value (except human eggs or sperm). Proper safeguards, of course, must be put in place to insure that donors donate or sell healthy products and donate or sell voluntarily. Virtually any factor relevant to the quality of the donated or sold body product could be factored into the purchase price listed by the seller. Such factors could include all relevant aspects of the health or behavior of the donor or seller. Purchasers of body products should be entitled to full access to a donor’s or seller’s medical records for purposes of researching the health and behavior of the donor or seller.
One of the functions of government should be to maintain a database or registry of people who have decided to be or not be organ donors and who have communicated this decision to their spouse and family. This way, hospitals and medical organizations can have quick access to such a database of information and promptly, after an accident, determine who is a donor and quickly proceed to salvage their organs.
People are Donors Unless They Opt Out
By default, people should be assumed to be organ donors unless they opt out of the donation program. This question should be asked of every individual once upon reaching the age of majority and every 5 years thereafter by their healthcare provider (most logical) or perhaps upon renewal of driver’s licenses.
Donors Receive Priority Over Non-Donors For Available Organs
Because organ donors have already agreed to make their organs available for donation, they should be rewarded by being given priority over non-donors for organs that become available for donation. This should be true regardless of the severity of the need for an organ by a non-donor. Non-donors may be able to ‘buy their way’ onto the recipient list by paying several times the market rate for the needed organ.
Donors May Influence Who Get Their Organs
Individuals who donate and sell their body parts would be allowed in most circumstances to significantly influence who the final beneficiary of the body part would be, even if they died or are incapacitated, by making such provision known in a will or other final document. Providers could specify that their products first go to help immediate family members listed on a national body parts waiting list or to relatives if they are listed as among the 90% who have waited the longest. In cases where multiple family members or relatives have a similar need for organs and if the donor is unable to make a decision as to which specific family member should receive an organ, the donor’s immediate family members (parents, siblings, children, but not minors) would vote for a prospective family recipient. If there is no need among this group, body part providers would be able to select long-time friends (friends of over 5 years) if the friend is listed among the top 50% of patients who have been on the national waiting list the longest.
However, potential transplant recipient qualifications should include how much additional living time the recipient would likely experience due to the transplant. In addition, age should play a factor. A 30 year-old should get priority over a 60 year-old. Incapacitated or deceased body part providers could also have a say in who could get their body parts by including the names of people in a will or other final document, so long as such named people meet the criteria listed above. Organs could also be donated to a chosen member of the general population if that person is listed among the 50% of people on the national list who have waited the longest for that kind of organ. The donor could even create a list of qualities or physical characteristics that he/she would wish the recipient to possess as prerequisites to receiving the organ donation. If the donor had given permission, his/her family could choose this member of the general population as a recipient. Donors could request that the top recipients in either their city, county, or state be given priority to their organs. Such requests should be honored so long as such a candidate is found to be among the top 50% of those on the national waiting list.
If no potential recipient of a body part provider is identified in any of the preceding special categories of people, then the medical healthcare providers would decide upon the most qualified and desirable recipient who should get the body part based on pure need.
Payment for Donated Body Parts
All donors, even deceased donors, should be paid market rates for the organs they donate. In the case of deceased donors, payment would be made to the spouse, family, relatives or to a person of the donor’s choice.0 Comments
Destructive research should only be allowed (with parental consent) on embryos and fetuses that meet the qualifications for abortion as well as those which have been naturally miscarried.
If human stem cells or fetal tissues can be harvested from an embryo without significantly damaging or destroying it, such harvesting should be allowed for virtually any purpose and from virtually any embryo with parental consent.0 Comments
Parents should be educated about and encouraged to choose to bank their child’s umbilical cord blood, especially if medical conditions exist in the child that make the future use of cord blood likely. Parents could choose to donate the cord blood for free to a public bank for the benefit of the general public, or they may choose a private blood banking service to ensure its availability and use for the child or anyone else authorized by the parents.
Parents who have purchased a private cord blood banking service have already purchased their exclusive use rights. However, parents who have donated to the public cord blood bank would need to pay market prices for any cord blood they may need in the future. Except for children who have been born with a known possibility that they may need their own cord blood in the future, there would be no guarantee that an individual’s cord blood donated at birth would be there for their own use in the future. Nevertheless, as soon as it is known that an individual would need the use of their own cord blood, an immediate search of the national cord blood database would check to make sure that the original cord blood is still available. If it is still available, it would immediately be removed from circulation and reserved for the individual diagnosed as potentially needing to use it.
Universal Cord Blood Banking Fee
There should be a mandatory fee of $500 for every live birth dedicated to funding a national cord blood banking system. Ideally, this system should be set up so that all the revenues generated by the $500 per birth fees and the selling of cord blood to needy individuals/families as well as to research scientists will at least cover all of the expenses associated with running this national umbilical cord blood banking system. Donors to a public bank would not be compensated if their cord blood is sold to another party.0 Comments
There should be a statewide or even a nationwide computer databases that can be accessed within seconds by any pharmacy within that jurisdiction, or at least within five minutes at most, so that customers who happen to go to a different pharmacy, but still within the state or country, wouldn’t be required to wait 15-30 minutes so that the pharmacies can transfer the customer’s records before any prescription medicines can be transacted.
Furthermore, pharmacists should be allowed access to a patient’s full medical records and information so that the pharmacist could better serve the patient. Access to such records would allow pharmacists to reduce the likelihood of prescription errors and better inform the patient about possible drug interactions.
“Prescriptions are an extension of a patient’s medical records and [pharmacists should have access to that person’s] critical information, including diagnosis, age, and weight” and perhaps other parameters. All this information should be kept confidential, of course. (Henri R. Manasse, Jr. USA Today 7-23-03)0 Comments