COVID-19 Antibody Testing as a Precondition for Employment: Ethical and Legal Considerations.

Employers and governments are interested in the use of serological (antibody) testing to allow people to return to work before there is a vaccine for SARS-CoV-2. We articulate the preconditions needed for the implementation of antibody testing, including the role of the U.S. Food & Drug Administration.

The need for health AI ethics in medical school education.

Health Artificial Intelligence (AI) has the potential to improve health care, but at the same time, raises many ethical challenges. Within the field of health AI ethics, the solutions to the questions posed by ethical issues such as informed consent, bias, safety, transparency, patient privacy, and allocation are complex and difficult to navigate. The increasing amount of data, market forces, and changing landscape of health care suggest that medical students may be faced with a workplace in which understanding how to safely and effectively interact with health AIs will be essential. Here we argue that there is a need to teach health AI ethics in medical schools. Real events in health AI already pose ethical challenges to the medical community. We discuss key ethical issues requiring medical school education and suggest that case studies based on recent real-life examples are useful tools to teach the ethical issues raised by health AIs.

Criminal Justice or Public Health: A Comparison of the Representation of the Crack Cocaine and Opioid Epidemics in the Media.

CONTEXT: The opioid epidemic is a major US public health crisis. Its scope prompted significant public outreach, but this response triggered a series of journalistic articles comparing the opioid epidemic to the crack cocaine epidemic. Some authors claimed that the political response to the crack cocaine epidemic was criminal justice rather than medical in nature, motivated by divergent racial demographics. METHODS: We examine these assertions by analyzing the language used in relevant newspaper articles. Using a national sample, we compare word frequencies from articles about crack cocaine in 1988-89 and opioids in 2016-17 to evaluate media framings. We also examine articles about methamphetamines in 1992-93 and heroin throughout the three eras to distinguish between narratives used to describe the crack cocaine and opioid epidemics. FINDINGS: We find support for critics' hypotheses about the differential framing of the two epidemics: articles on the opioid epidemic are likelier to use medical terminology than criminal justice terminology while the reverse is true for crack cocaine articles. CONCLUSIONS: Our analysis suggests that race and legality may influence policy responses to substance-use epidemics. Comparisons also suggest that the evolution of the media narrative on substance use cannot alone account for the divergence in framing between the two epidemics.

Revisiting the anaesthesiologist's role during organ procurement.

As organ transplantation science continues to mature, both physicians and the public face challenges defining death and, subsequently, caring for an individual when they are deemed eligible for organ procurement. This paper revisits the anaesthesiologist's role with respect to the provision of analgesic medication at the time of organ procurement. It provides a historical overview of the ethics of organ procurement, explaining how the definition of brain death and the ethical principle of the 'dead donor rule' have shaped the practice of organ procurement. It concludes by suggesting that a re-framing of the ethics of organ procurement may be necessary in order for anaesthesiologists to meet their ethical obligation of preventing harm to organ donors while maintaining public trust in the medical profession.

Chronic postsurgical pain and persistent opioid use following surgery: the need for a transitional pain service.

AIM: To identify the 3-month incidence of chronic postsurgical pain and long-term opioid use in patients at the Toronto General Hospital. METHODS: 200 consecutive patients presenting for elective major surgery completed standardized questionnaires by telephone at 3 months after surgery. RESULTS: 51 patients reported a preoperative chronic pain condition, with 12 taking opioids preoperatively. 3 months after surgery 35% of patients reported having surgical site pain and 13.5% continued to use opioids for postsurgical pain relief. Postoperative opioid use was associated with interference with walking and work, and lower mood. CONCLUSION: Chronic postsurgical pain and ongoing opioid use are concerns that warrant the implementation of a Transitional Pain Service to modify the pain trajectories and enable effective opioid weaning following major surgery.