Recent Newspaper & Online Columns by Kate Scannell MD

Dr. Kate Scannell: New York's soda tax battle pits government role against personal liberty

March 20, 2013

Tags: ethics, new york soda ban, government, personal liberty, obesity, Bloomberg, soda

By Dr. Kate Scannell, Syndicated columnist
First published in Print: 03/17/2013

Last Monday, a judge canned New York City's revolutionary plan to prohibit the sale of large, high-caloric, sugar-sweetened drinks in restaurants, movie theaters, and other food venues -- just one day before the ban was supposed to take effect. The ruling dealt a blow to the city's Board of Health and Mayor Michael Bloomberg who were promoting the ban as a means to address the obesity epidemic.

Had the deliciously-named judge -- Milton Tingling -- not overturned the so-called "soda ban," today it would be permissible in establishments under the health department's purview to celebrate St. Pat's in Manhattan with pitchers of manhattans, but nothing larger than 16-ounce servings of sugary beverages.

This has stirred much debate about the proper reach of government into our private lives. Can -- and should -- the government regulate the sipping point of our thirst for sugar, the critical ounce beyond which our intake tips toward transgression? (more…)

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Armstrong doping scandals reveals much about society as a whole

October 28, 2012

Tags: Armstrong doping scandal, Lord of the Flies, blood doping, sports enhancements, ethics, USADA

By Dr. Kate Scannell
First published in print: 10/28/2012

I'm going to ask my nephew to read the 202-page report issued last week by the United States Anti-Doping Agency that summarizes the doping allegations against cyclist Lance Armstrong by his own teammates and entourage. It's a powerful document that stimulates critical thinking about sportsmanship and athletic competition, and it raises important ethical issues about athletes' pervasive use of performance-enhancing drugs.

Because the report cobbles together stories from professional athletes who broke a code of silence that had tethered them to a troubling team secret, it also offers insights about these issues from the experiences of intimate insiders. No aunt or school health counselor can compete with that for the prized attention of a serious young man trying to imagine what life might be like as a professional athlete.

At times, the USADA report reads like William Golding's classic novel, "Lord of the Flies." On a literal level, we learn what happens when a group of (mostly) men are sequestered on an island (team) of their own making and self-governance, without effective supervision by oversight agencies that are supposed to enforce publicly agreed-upon rules of conduct.

In short order, leaders emerge within the team and regularly break those rules. A new regime supplants the old order and, ultimately, everyone comes to fear retaliation if they don't comply with the new norm. So they take the secret handshake -- or the blood doping, the growth hormone, the steroids. (more…)

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Medicine under the influence -- Abbott's off-label drug promotions

May 27, 2012

Tags: off-label drug promotion, Abbott, Depakote, conflicts of interest in medicine, ethics, evidence based medicine

By Dr. Kate Scannell, Syndicated Columnist; First published in print: 05/27/2012

When I was a young girl, I watched my mother use a small amount of carbonated cola to successfully remove a rusty stain from our kitchen sink. I was amazed -- and a bit worried -- that a beverage I regularly consumed could also serve as a powerful stain remover.

Inspired by my mother's wizardry, I wondered what else the cola might do. Let's just say that experimentation allowed me to discover that the cola could not remove freckles from my little sister's face. And it failed as fuel for my father's cigarette lighter.

Obviously, the cola manufacturer made no marketing claims about its beverage other than encouraging its use as a tasty thirst quencher. My mother and I had freely chosen to use the cola for wholly unapproved uses -- notably, with both success and failure.

After becoming a physician, I discovered that we doctors often prescribed medications for unproven and unapproved uses. We would speculate how a drug proven useful by research to treat a specific illness might work for other diseases as well. That ostensible leap of faith into "the art of medicine" usually entailed a dollop of scientific hypothesis and a dash of hope, and it was generally taken only when a known cure for a patient's disease did not exist. Notably, both remarkable successes and lamentable failures ensued.

There is much talk today about "evidence-based medicine" providing the great corrective to drug-prescribing and medical practice guided by hunch and hope. In theory, evidence-based medicine operates on the assumption that judicious analysis of all the published evidence concerning a particular treatment will lead to an accurate assessment of that treatment's true effects. (more…)

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When patients are treated like ATMs, conflicts sure to arise -- Medical Devices

July 10, 2011

Tags: Infuse, medical devices, Medtronic, conflicts of interest, ethics, The Spinal Journal

By Dr. Kate Scannell
First Published in Print: 07/10/2011

A FEW weeks ago, I visited a hospitalized friend who was recuperating from hip-replacement surgery. While unpacking the deli items I promised to bring, he said, "Too bad! You just missed my orthopedic surgeon. He invented my hip replacement!"

"Really?" I said, almost spilling a carton of matzo ball soup.

"Yeah, he designed and patented it!" my friend bragged. "And he uses it in all of his hip surgeries!"

But I didn't feel as hip-hip-hooray about the news. An orthopedic surgeon inserting his patented, royalty-generating medical device into my friend's body as though it were an ATM card?

As a rheumatologist who'd cared for many arthritic patients needing joint replacements, I knew that the medical-device market was already steeped with tried-and-true hip replacement models. How could my friend have possibly evaluated the safety and efficacy of his surgeon's new -- and, undoubtedly, more expensive -- device? Was he aware that it had no known or knowable track record? What authentic choice did he truly have when consulting with his one-hip-wonder surgeon? (more…)

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Who really owns your spleen?

September 19, 2010

Tags: biobanks, ethics, consent, tissue storage, Tony Bennett, Kate Scannell, Henrietta Lacks

By Kate Scannell MD, Contributing columnist Bay Area News Group

BELIEVE IT or not, parts of your own body might not always belong to you.

Tony Bennett may have famously -- and figuratively -- left his heart in San Francisco. But with much less fanfare -- and, quite literally -- people routinely leave behind parts of their organs and tissues in hundreds of cities across the country every single day.

They leave biopsies of skin, breast, liver, prostate, bone marrow -- you name it -- to doctors, hospitals, and diagnostic centers. Sections of their colons, lungs, and limbs are removed during surgeries, sent to labs for pathologic examination, and ... then what? (more…)

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