Consequences of blowing the whistle in medical research.
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Biomedical subjects
Publications and source records attributed to M Shuchman.
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Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Toronto physician Miriam Shuchman has spent the last 4 months tracking the research issues surrounding a controversial clinical trial conducted in Toronto. Much of the information appearing in this article was gathered while she was preparing a segment for the CBC Radio program Quirks and Quarks. Earlier, she had reported on similar issues in the US for the Annals of Internal Medicine.
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The public is poorly served by the coverage of medical science in the general press. Scientists and physicians blame the press, claiming that journalists are careless in their reporting, subject to competitive pressures, and ignorant of the scientific process. Journalists accuse the medical community of limiting access to information and erecting barriers to the public dissemination of medical research. In many areas of health news reporting, the underlying problem is an interactive dynamic that involves scientists and journalists. Both parties share the responsibility for accurate communication to the public. This report suggests ways to improve health news reporting, focusing on four problem areas: sensationalism, biases and conflicts of interest, lack of follow-up, and stories that are not covered.
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To examine responses to the psychological needs of adolescent injury victims, the records of all adolescents hospitalized at an urban trauma center during a one-year period for injury by gunshots, stabbings, and physical assaults (N = 59) were compared with the records of adolescents admitted that year for attempting suicide (N = 28). Victims of intentional injuries received significantly lower levels of psychosocial interventions than suicide attempters, and access to such interventions appeared to be influenced by gender and race. Intentionally injured adolescents may not receive available interventions for the psychosocial consequences of their injuries.
The authors evaluated the accuracy of clinical impressions and Mini-Mental State Exam scores for assessing patient capacity to consent to major medical treatment, relative to expert psychiatric assessment. Consecutive medical inpatients (N = 63) facing a decision about major medical treatment received a clinical impression of capacity from their treating physician and the Standardized Mini-Mental State Exam (SMMSE); 48 received independent psychiatric assessment of capacity. Analyses revealed that both clinical impressions and SMMSE scores were generally inaccurate in determining capacity, although all 23 participants with a clinical impression of "definitely capable" were found capable by the psychiatrist. Given the importance of assessing capacity to consent to major medical treatment, better approaches to the clinical assessment of capacity are required. Several strategies are discussed.