David Eckert, from Hidalgo County, New Mexico, was subjected to numerous, highly invasive procedures, because police suspected him of hiding drugs in his rectum. Mr. Eckert had been convicted of methamphetamine possession in 2008, and the police suspected his continued involvement with drugs. However, the officers who searched both Mr. Eckert’s person and his vehicle, after pulling him over for a traffic violation, found neither drugs, nor weapons. One officer indicated that Mr. Eckert held himself in an “erect” position, and “kept his legs together,” which led the officers to assume that Mr. Eckert held drugs within him.
After a local hospital refused forcibly to search Mr. Eckert, he was transported to the Gila Regional Medical Center (GRMC), 50 miles away. At GRMC, Mr. Eckert was subjected to two rectal exams, three enemas, forced bowel movements in front of officers and nurses, x-rays, and a colonoscopy performed under anesthesia. However, each search was fruitless. Mr. Eckert received a bill from the hospital for $6,000. Mr. Eckert filed suit against the hospital, and the parties settled for $1.6 million.
“Redressing Past Wrongs: Changing the Common Rule to Increase Minority Voices in Research” (forthcoming, American Journal of Public Health) states that the underrepresentation of minorities in human subject research is particularly alarming because many diseases are more prevalent in minority populations, irrespective of age, gender or income. The article suggests that minority underrepresentation reflects minorities’ mistrust of the government, due, in part, to cases of abuse of minorities in human subject research; and, minorities’ comparative lack of access to health care, leading to fewer opportunities for minorities to participate in research.
The article was co-written by Bill Rencher, the health access program director of the nonprofit, Georgia Watch, and Leslie Wolf, Professor of Law at Georgia State University, and it appears in a special issue on the Ethics of Human Subjects Research in Minority Populations. The authors suggest that federal regulations be changed to protect minority populations as they protect prisoners, children and pregnant women.
The European Union (EU) began to regulate “working time” in 1993. The work week is limited to forty-eight hours, averaged over four, six or twelve months; minimum rest periods between shifts are required; and, an employee must receive one day off for every seven days of work and two days off for fourteen days of work. Ireland implemented measures in accordance with the EU working-time directive; however, the measures did not apply to junior physicians. By 2009, junior physicians’ hours were regulated also, and limited to 48 per week, but the practice implemented by health institutions has not complied with the law. The EU issued a formal notice to Ireland to address its non-compliance in 2011. Also, physician groups are advocating against what they call “dangerously long working hours.” However, some wonder if the working-hours directive directly conflicts with the duty of the public health system to provide “around-the-clock care.”
Recently, during attempts to resolve the budgetary deadlock, the Obama administration offered members of Congress continued federal funding towards insurance premiums under the Affordable Care Act (ACA)—provided that they enroll in a specified ACA plan. Currently, almost all federal employees are eligible for the Federal Employees Health Benefits Program (FEHBP). On average, FEHBP pays approximately 70 percent of the total cost of the enrollees’ insurance premium.
The Office of Personnel Management (OPM) issued proposed rules; the OPM reasoned that the ACA did not repeal the FEHBP, and stated that government subsidies for insurance premiums should continue for federal employees compelled to leave FEHBP. However, numerous commentators opine that those in Congress should be subject to the same rules as other U.S. citizens.
The National Institute of Health (NIH) will grant twenty-five million dollars, over the next five years, in order to examine health, privacy, economics, interpersonal issues and newborn genomic screening. The NIH will take DNA samples from newborns, from four U.S. cities; however, many of the parents and children involved will have no notice that their DNA is being studied.
The goal of the NIH is to discover whether it is economically feasible to obtain every newborn’s DNA for analysis purposes. Currently, newborns are screened for twenty-six manageable, or even preventable, conditions or diseases. The current screening costs approximately one-hundred dollars; however the new genomic screening costs approximately five-thousand dollars. In addition, some are concerned that, if genomic screening proves successful, many parents may limit their children’s activities in order to protect them from disorders that may never develop.
Recently, USA Today conducted an investigation in order to ascertain whether state medical boards are taking appropriate disciplinary measures for doctors guilty of “serious misconduct.” The findings are disturbing; for example, one finding shows that from 2001 to 2011, fifty-two percent of doctors who had their clinical privileges removed by a medical institution were not punished by a state medical board. Although hospitals and other healthcare related entities are required to report disciplinary actions involving doctors to the National Practitioner Databank, typically only a state medical board can affect a doctor’s actual license.
Despite the investigation’s findings, Lisa Robin, chief advocacy officer at the Federation of Medical Boards, maintains that state medical boards “‘take their responsibility very seriously in taking actions, being thoughtful, and … protecting the public.’” Taking disciplinary action can be an intricate pursuit for state medical boards, often involving complex legal issues such as due process and patient confidentiality. To further complicate matters, many state medical boards are operating under strict budgetary constraints.
China’s State Administration for Industry and Commerce (SAIC) is increasing its investigatory efforts into the Chinese pharmaceutical industry and medical services sector. The SAIC is focusing on the price of medicine, and whether companies are in violation of anti-trust legislation. The SAIC will severely punish those engaged in acts of bribery in the bidding process for pharmaceuticals and medical services because bribery inflates prices artificially and hurts consumers.
Last Tuesday, March 5, 2013, Juan Mendez called for an international debate on health care abuse that is akin to “torture or cruel, inhuman, or degrading treatment or punishment.” Mr. Mendez, a Special Rapporteur to the United Nations, believes such a debate is necessary in light of his report to the Human Rights Council, which was released in February. The report highlights certain abuses, including: “compulsory detention for drug users, street children, homeless individuals, and others in rehabilitation centers run by military or police; violation of reproductive rights such as involuntary sterilization, female genital mutilation, and denial of abortion or post-abortion care; denial of pain treatment; solitary confinement and prolonged restraint of persons with psychosocial disabilities; and denial of treatment to HIV/AIDS patients and lesbian, gay, bisexual, transgender and intersex persons.” Read more here and here.