Health Care

The New England Journal of Medicine is at it again. It just published a dire warning that deporting illegal aliens will hobble our healthcare system. First, the authors give a dubious example of the kind of calamity that will supposedly happen to our most vulnerable patients without illegal immigrant workers. From, “Who Will Care for America?“: As physicians, we have witnessed firsthand the harms that such policies pose to patients and health care workers alike. In one case we know of, an older patient with metastatic cancer fell at home and lay on the floor for days before being found by a family member; he died shortly after being admitted to a local hospital. Though it’s uncertain whether he would Read More ›

Last month, I wrote about Adriana Smith, the pregnant young mother who tragically experienced blood clots in the brain and was declared dead by neurological criteria. Adriana’s body was maintained with mechanical support to allow her baby to be gestated. I thought that was the right decision. Here is how I analyzed the situation in my post: That column was quite controversial — something new for me (eye roll) — and I received many angry responses (as well as expressions of support). Most of my critics claimed that it was somehow undignified to force a dead woman to gestate a baby. I heard the trite Handmaid’s Tale trope more than once. Well, time has passed, and thankfully Adriana’s baby was Read More ›

As established by the great medical humanitarian, the late Dame Cecily Saunders, hospice was designed to treat “total pain” of patients — whether physical, emotional, or spiritual — to the end of ensuring that the care offered is about living, not just death. When it works as intended, as it did for both my parents, the beneficence offered to patients and their families cannot be quantified.

Alas, the hospice movement is in serious trouble. I can’t tell you how often now people approach me after a speech or call in on talk radio to tell me that they do not trust hospice to properly care for their loved ones.

Why has this happened? My friend Ira Byock, the great palliative doctor and author of Dying Well, has noted that the for-profit sector of the industry too often does not live up to the hospice promise of profoundly personal and compassionate care. Also, there is a problem with fraud and abuse, about which, Byock insists, there must be institutional “zero tolerance.” In addition, the integration of palliative care within the American health system has stalled, despite demonstrating that quality care for seriously ill and dying people is both feasible and affordable.

And from my perspective — not Byock’s — the assisted suicide movement has been a body blow to the hospice movement. Partly this is because the media is so besotted with “aid in dying” propaganda that there is little room left to tell good hospice stories. But I also blame institutional hospice organizations, which pretend that assisted suicide isn’t a mortal threat to the hospice philosophy. As a consequence of this institutional cowardice, all one hears from hospice organizations about legalizing assisted suicide is the proverbial sound of silence, further diminishing the importance of the sector.

What a tragedy. A Georgia woman named Adriana Smith was two months pregnant when she suffered blood clots to the brain and was later declared deceased by neurological criteria, i.e., “brain dead.” Under the law, that means Adriana’s body is a cadaver. The medical team has kept her body functioning so that her baby can continue to gestate. The baby is now at 21-weeks gestation, which is close to viability. (Whether a true corpse can gestate for months is a different question that I won’t address here.) From the AP story: Smith’s family says Emory doctors have told them they are not allowed to stop or remove the devices that are keeping her breathing because state law bans abortion after cardiac activity Read More ›

“Futile care” is a bioethics theory in which doctors are authorized to refuse wanted life-sustaining treatment based on their belief about the quality of a patient’s life. It can be cruel — and on occasion, mistaken. Prominent medical journals usually support futile-care theory. But the New England Journal of Medicine just published a contrary column by a compassionate doctor who rejected that approach in order to keep hope alive for his terminally ill patient and her family. The oncologist, Dr. David N. Korones, placed a young terminally ill cancer patient named Zoha in an experimental drug trial. At first all seemed well, then her condition worsened. From, “The Last Dose”: Although the rules of the trial allowed Zoha to remain Read More ›

There are some 91,000 people with severe kidney disease waiting for transplants. Alas, cadaver and living donors are insufficient to fill the need. That has some well-meaning activists pushing to increase the number of available kidneys by legalizing organ-selling. The psychiatrist and American Enterprise Institute senior fellow Sally Satel is probably the premier proponent of this approach. She has skin in the game, having received two living-donor organs. Writing in the Free Press, Satel promotes a bill that would allow kidney suppliers to become vendors and receive a tax credit. From, “I Had Two Kidney Transplants: I Want Donors to Get Paid.” But now, legislation is on the table that would save these patients’ lives while eliminating those concerns. On Read More ›

As many Western countries reverse their former embrace of so-called “gender-affirming care” as it applies to children, the American medical establishment has obstinately pretended that puberty blockers and transition surgeries are medically uncontroversial. The latest example: An advocacy article published in the February 12, 2025 New England Journal of Medicine — yet again — decrying laws passed to protect children from transition interventions. From “Advancing Transgender Health amid Rising Policy Threats” (citations omitted): Gender-affirming care is a cornerstone of multidisciplinary health support for transgender and nonbinary people; it is widely recognized as essential, evidence based, and often lifesaving. The standards of care issued by the World Professional Association for Transgender Health emphasize the critical role of interventions such as pubertal Read More ›

No matter election outcomes, presidential executive orders, and the ebbing support for the “woke” agenda among the general public, the medical establishment — epitomized by the New England Journal of Medicine — continues to push DEI ideology in medical school admissions policies. A recent advocacy article in the NEJM pledges fervid fealty to DEI, primarily focusing on gender ideology. From, “Facing Political Attacks on Medical Education — The Future of Diversity, Equity, and Inclusion in Medicine” (citations omitted): In recent years, the United States has seen an onslaught of legislation aimed at dismantling diversity, equity, and inclusion (DEI) initiatives in higher education, including medical education. Although these legislative actions are often construed as focusing only on race, they also explicitly or implicitly target members of Read More ›

With Texas experiencing a measles outbreak, some might expect RFK to play down vaccines or damn them with faint praise. Nope. He wrote an op-ed piece for Fox News praising the MMR vaccines — in a manner consistent with his belief that the decision to inoculate should be a matter of choice. From “Measles Outbreak Is Call to Action for All of Us:” Parents play a pivotal role in safeguarding their children’s health. All parents should consult with their healthcare providers to understand their options to get the MMR vaccine. The decision to vaccinate is a personal one. Vaccines not only protect individual children from measles, but also contribute to community immunity, protecting those who are unable to be vaccinated due to Read More ›