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May 17, 2011

Don't believe television, autopsies are very rare

40% of hospitals don't perform any autopsies at all. There is a great fear of uncovering information after death of a patient that might reveal that a doctor did something wrong. So they don't do them. It used to be that hospitals had to do a certain number of autopsies to remained accredited--before 1970 it was 20%--but that changed and now they basically are not performed. Set aside the malpractice concerns for a moment and just think about what we are failing to learn from all these dead people. It's absolutely shocking that this is standard procedure. What's more important: healing people, or making money? The answer in this case seems obvious. Autopsies, which can reveal medical secrets, are now rare in U.S. hospitals - The Washington Post
Television crime shows have helped popularize autopsies, but in reality these postmortem exams are becoming rarer every year. Today, hospitals perform autopsies on only about 5 percent of patients who die, down from roughly 50 percent in the 1960s. That’s unfortunate, say experts, because details about the cause of death can be illuminating for both families and hospitals, even if they don’t turn up an undiagnosed ailment or other new information about the cause of death. Kristine Johnson’s father, Nathan Johnson, developed early-onset Alzheimer’s disease and died last August, five years after having received that diagnosis at age 52. He worked as a lineman for a power company near the family home in Waterford, Conn., and had on occasion been injured by powerful jolts of electricity, says Kristine, who is 36. She hoped that an autopsy would provide some answers, possibly related to injuries he sustained on the job, that would explain why he developed Alzheimer’s at such an early age. (Most people who develop Alzheimer’s do so after age 65; only about 5 percent of cases are early-onset.) . . . Autopsies play a critical role in helping to advance understanding of the progress of a disease and the effectiveness of various treatments. At the same time, they may identify medical conditions that clinicians and high-tech imaging miss or misdiagnose. For example, Elizabeth Burton, deputy director of the autopsy service at Johns Hopkins Hospital in Baltimore, recalls that when she autopsied a 50-year-old alcoholic patient, what appeared to be cirrhosis of the liver was actually cancer. Autopsies can also reveal a range of conditions with hereditary implications, from cancer to cardiovascular disease, says Burton, who is a physician. Current research is scarce, but in 1998 the Journal of the American Medical Association reported that autopsy results showed that clinicians misdiagnosed the cause of death up to 40 percent of the time. With the increasing use of high-tech imaging equipment, “maybe the error rates are better now,” says George D. Lundberg, who wrote the JAMA piece while he was the editor of that journal. (He is now an editor-at-large at MedPage Today, a medical news Web site.) . . .

May 16, 2011

Is conscription slavery?

An interesting discussion here. Overcoming Bias : Conscription Is Slavery
Slavery is involuntary servitude; conscription is involuntary military servitude; therefore not only is conscription slavery; it’s a particularly heinous form of slavery that often ends in maiming and death. Yet most people disagree – and so did the U.S. Supreme Court back in 1918. … I think I finally figured out what most people are thinking. Namely: They implicitly regard slavery not as mere involuntary servitude, but as low-status involuntary servitude. … conscripts have high status – and therefore can’t be slaves.