Faculty Bibliography

In the wealthy nations of the world, access to implantable cardiac rhythm management devices is widespread. In many underserved low- and middle-income countries (LMIC), where cardiovascular disease is fast becoming a major public health problem, access is often limited. Reuse of pulse generators was practiced regularly in some European nations in the 1990s with good results. It is performed in LMIC, although the rates of device reuse are unknown. The available literature suggests there is no increased risk of morbidity or mortality with the reuse of devices. Donations of pacemaker and defibrillator pulse generators from developed nations constitute an important source of devices for the poor in LMIC. There are opportunities to increase this supply, but logistical barriers and legal and ethical concerns must be addressed. With proper sterilization, meticulous chains of custody, and advance directives for device handling (pacemaker/defibrillator living wills), patients in LMIC who would otherwise lack access to these devices could benefit from their reuse.

AIM: We surveyed physicians' opinions and acceptance of influenza immunization. SCOPE: A web-based survey was sent to all physicians in two academic departments during spring 2009. RESULTS: 227 (40.5%) physicians responded. Physicians who frequently cared for high-risk patients self-reported higher immunization rates than physicians with infrequent contact (P=0.0002). There were no significant differences in immunization rates between emergency medicine (EM) and internal medicine (IM), between those with and without children at home, nor by age group. A majority (84.6%) supported mandatory vaccination. IM physicians were more supportive of mandates than EM physicians (P<0.0001). CONCLUSION: Self-reported immunization rates were high among study physicians. Acceptance of mandatory vaccination was substantial, but varied by specialty.

There is increasing pressure for neuroscientists to communicate their research and the societal implications of their findings to the public. Communicating science is challenging, and the transformation of communication by digital and interactive media increases the complexity of the challenge. To facilitate dialogue with the public in this new media landscape, we suggest three courses of action for the neuroscience community: a cultural shift that explicitly recognizes and rewards public outreach, the identification and development of neuroscience communication experts, and ongoing empirical research on the public communication of neuroscience.

Chaplan comments on the latest trend of reproductive technology, where doctors put more than one embryo. No clinic should be putting more than two or three babies into even a younger patient who has already shown she can create children through success in previous rounds of in vitro fertilization. If the only way to prevent such outrageous treatment is to pass a law penalizing any doctor who implants numerous embryos under such circumstances, then let's get such a law passed

Caplan discusses the four problems with the conclusion that the way to combat organ trafficking is to make it legal. First, there is no reason to think that most nations have the resources to regulate a market in organs effectively. After all, even the US, Britain, and Germany proved unable to regulate their banking, housing and securities sectors. Second, there are other ways to expand the availability of organs and tissue that do not involve treating human beings as commercial body-parts factories. Nations could institute presumed-consent policies, asking those who do not want to be donors to carry cards or register their objection in computer registries. When supplemented with appropriate training and resources, these systems have proven very effective in Spain, Belgium, Austria, and other nations. Third--and perhaps the greatest problem with legalizing organ and body-part markets--is that such markets prey on the grim circumstances of the poor. Fourth, they clearly violate the medical ethics of physicians and health-care workers

Caplan depicts a situation where conflict between parents and doctors right to determine if one of the patients or family members who was diagnosed with a highly malignant disease is dead. He further discusses whether family's religious view of death and the doctors' professional rights to declare death affects the decision of whether an individual is already dead. He explains that the determination of death is best left in the hands of doctors. The determination of when to end care that is completely and utterly futile because the patient has died is also best left to doctors. As much as death may trigger religious activity on the part of many, religion should never trump science when it comes to deciding when death has occurred in a hospital and what to do about the fact