Breast implants - protection or paternalism?

Article Abstract:

Dr. David A. Kessler, the commissioner of the Food and Drug Administration (FDA), has removed silicone-gel breast implants from the market. He believes that manufacturers of implants have not proved the safety of their product. He also argues that the risks of implants have not been defined. He says little about their benefits. Implants may improve the quality of life of women who undergo breast augmentation surgery or breast reconstruction after a mastectomy. The FDA's decision may force women with breast cancer to participate in clinical studies because it is the only way to get implants after mastectomy. It may have created unnecessary fear among women who already have implants. It may discriminate against women by limiting the availability of a device used mainly by women. The FDA may be trying to protect women's health, or it may be restricting their right to make their own choices.

Laws, regulations and rules, Ethical aspects, Breast implants, United States. Food and Drug Administration, Paternalism, Silicones in medicine, Medical silicones

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Is academic medicine for sale?

Article Abstract:

Doctors who are faculty members at medical schools and teaching hospitals should divest themselves of some of their financial ties to the pharmaceutical and medical device iindustry. One reason for the close relationship between medical schools and industry is to allow research ideas to be developed and then transferred to a company that can manufacture and distribute the drug or medical device. Many medical schools badly need the money that the pharmaceutical industry provides, often in the form of research centers and teaching programs. However, these arrangements can bias doctors in favor of industry when they should be focusing on patients.

Analysis, Conflict of interests (Agency), Conflicts of interest (Agency), Hospitals, Teaching, Teaching hospitals

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Fixing Medicare

Article Abstract:

The best way to fix Medicare is to eliminate fraudulent bills, regulate the most expensive services and re-evaluate the enrollment of Medicare beneficiaries into managed care. Congress and Pres Clinton have encouraged Medicare beneficiaries to enroll in HMOs but many elderly patients are reluctant to do this. HMOs do a good job of providing preventive services but are not financially motivated to provide expensive care that many elderly patients need. Many elderly patients enroll in HMOs when they are healthy and drop out when they get sick so they can use a fee-for-service system.

Care and treatment, Aged, Elderly, Innovations, Managed care plans (Medical care), Medicare

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