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Howard Brody

Publications and source records attributed to Howard Brody.

30 records · Page 2Linked to original sources
PubMed1992

Medical Ethics Resource Network of Michigan: development of a statewide ethics network.

The Medical Ethics Resource Network (MERN) of Michigan has, over approximately 5 years, become a viable organization for disseminating educational information and raising the general standard of ethics discussion in a variety of institutional settings. This article reviews the history of the network's development, with special emphasis upon features that may suggest useful strategies for other networks now under formation.

Administrative Personnel↗
PubMed1988

In the best interests of.

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Congenital, Hereditary, and Neonatal Diseases and ↗
PubMedDate not supplied

The company we keep: why physicians should refuse to see pharmaceutical representatives.

Whether physicians ought to interact with pharmaceutical sales representatives (reps) is a question worthy of careful ethical analysis. The issue presents a challenge to both professional integrity and time management. Empirical data suggest that interactions with pharmaceutical reps increase the chances that the physician will act contrary to duties owed to the patient. Ideally, a physician might both interact with reps and also do the research necessary to counteract the commercial bias in their messages. But a physician who actually did that research would, in turn, be devoting a good deal of time that might better be spent in other activities. The counterargument, that one is obligated to see representatives to obtain free samples to best serve one's patients, can be shown in most practice settings not to be compelling. Physicians ought to refuse to visit with representatives as a matter of both professional integrity and sensible time management.

Commerce↗
PubMedDate not supplied

BiDil: assessing a race-based pharmaceutical.

Isosorbide and hydralazine in a fixed-dose combination (BiDil) has provoked controversy as the first drug approved by the Food and Drug Administration marketed for a single racial-ethnic group, African Americans, in the treatment of congestive heart failure. Family physicians will be better prepared to counsel their patients about this new drug if they understand a number of background issues. The scientific research leading to BiDil's approval tested the drug only in African American populations, apparently for commercial reasons, so the drug's efficacy in other populations is unknown. Race as a biological-medical construct is increasingly controversial; BiDil offers a good example of how sociocultural factors in disease causation may be overlooked as a result of an overly simplistic assumption of a racial and hence presumed genetic difference. Past discrimination and present disparities in health care involving African American patients are serious concerns, and we must welcome a treatment that promises to benefit a previously underserved group; yet the negative aspects of BiDil and the process that led to its discovery and marketing set an unfortunate precedent. Primary care physicians should be aware of possible generic equivalents that will affect the availability of this drug for low-income or uninsured patients.

Black or African American↗
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A matter of influence.

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Conflict of Interest↗
PubMedDate not supplied

Addressing spiritual concerns in family medicine: a team approach.

Spiritual conflicts and concerns often accompany serious illness, but many family physicians are slow to recognize these concerns or unsure how to address them. The case of a patient with spinal cord injury and who later developed an astrocytoma is used to illustrate a team approach that involved a family physician, a spiritual counselor, and a psychologist. Narrative writing exercises in which the patient was encouraged to tell his own story also played a role in treatment. The case report includes the patient's own description of his experience with spirituality and spiritual counseling, as well as the perspectives of the spiritual counselor.

Adult↗
PubMedDate not supplied

A critique of clinical equipoise. Therapeutic misconception in the ethics of clinical trials.

A predominant ethical view holds that physician-investigators should conduct their research with therapeutic intent. And since a physician offering a therapy wouldn't prescribe second-rate treatments, the experimental intervention and the best proven therapy should appear equally effective. "Clinical equipoise" is necessary. But this perspective is flawed. The ethics of research and of therapy are fundamentally different, and clinical equipoise should be abandoned.

Beneficence↗