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Category: Health identities

How communicating about health contributes to the ways we answer the question, “Who am I?”

And when the shoe is on the other foot in health communication, so that a patient wants to reject treatment or medication, what then?

Jauary 17, 2012

Sometimes, life really is a race…

Here is my daughter pictured in a skull at the Head of the Charles rowing competition. Looking at it, I am thinking about how our discussion about conscience clauses ignores the other side of the story.

I was reminded of our right to refuse treatment based on our values and morals when I once more searched to find published research about how doctors, especially pharmacists, talk about these issues with patients when it means that a doctor/pharmacist is not going to provide medication or treatment.

Orr and Jensen conclude in the Journal of Medical Ethics,

“How should the clinician respond when a patient or family requests “inappropriate” treatment based on religious beliefs? As in all situations where there is disagreement about treatment options, good communication is the most important step towards resolution. The patient or family must clearly understand the medical situation. This may require repeated discussion, conversations with consultants,viewing of x-rays or other clinical data, or other efforts familiar to most clinicians. A management conference, which includes the patient/family, primary physician, consultants, bedside nurses and others from the care-team, is often the best way to ensure that such communication happens.” (1993, p. 145; http://jme.bmj.com/content/23/3/142.full.pdf+html)

The article’s title? “Requests for “inappropriate” treatment based on religious beliefs.”

I think the suggested course of communication in the decision-making scenario is a great model for how to talk about decisions when the shoe is on the other foot, so to speak…and the focus is conscience clauses and the provider’s religious beliefs.

 

 

 

What might happen when a pharmacist uses a conscience clause?

January 16, 2012

A conscience clause — when might a pharmacist feel conflicted about filling a prescription? The most commonly discussed event is birth control. Birth control pills, the morning after pill… these medications cause feelings of conflict between values related to pro-life and anti-abortion, and dispensing the medications.

The store, Target, supports a pharmacist’s rights not to fill these prescriptions. However, a pharmacist must direct a consumer to another Target store where the prescription can be filled. I can find no research that has been done to see how such conversations might take place or what happens when — as in the town where I live — there is one Target store. I don’t know if there is more than one pharmacist there. I don’t know if any of them object to filling these prescriptions. But if they do, what happens? How would I know? Who would tell me?

What is a conscience clause and how does it affect health communication?

January 14, 2012

Do you remember the first time that you heard the word ‘conscience’? I grew up in a household where my parents used the word and shaped my ‘conscience’ — my sense of right and wrong. And as an adult, I feel the twangs of my conscience guiding my decisions. I would hate to have a job where someone told me that I could not follow my conscience. It is hard enough to work in a job where and live in a world where not everyone shares my ‘conscience’. But at least I am able to behave based on my moral code, even if it doesn’t always reward me to do so.

Health care providers face challenges to their ability to act based on their conscience in some situations. Efforts have been made to adopt policies to allow health care providers to act based on their conscience. These ‘conscience clauses’ aim to allow doctors and pharmacists and other health care providers to choose not to provide some services because to provide the service would go against their conscience. Watch this video and we’ll talk more about this issue in the coming week.

Reading product labels and discovering hidden sources of ‘salt’ in vitamin supplements

January 10, 2012

When traveling over the holidays in crowded airports with many many many others, I often add a supplement to my daily routine. Airborne is one product I have used over the past several years. One of my sisters recommended Emergen-C and so I tried it. I liked it. It comes in tangerine and I like the flavor. Then I compared the cost…and that favored Airborne in the retail store where I was looking. So I flipped the products over to see if I could learn anything more to help me make a decision. And I did.

For some reason, Airborne has 230 mg or 10% of the daily recommended amount of sodium [salt] in a tablet. Yikes. I try to limit my salt intake. I eat reduced sodium products in nearly everything that offers a choice of low or reduced sodium. I wouldn’t want to take a simple supplement with so much salt in it if I could avoid it.

Emergen-C on the other hand only had 60 mg of sodium in one dose of the supplment. I don’t know why either product needs any sodium in it but finding nearly 400 percent more sodium in Airborne than in Emergen-C, I chose Emergen-C.

Moral of this story: do read the product labels even for supplements and vitamins to see what hidden sources of salt/sodium may be lurking in them.

 

Why laughter really is the best medicine

November 2, 2011

Several times recently, I’ve heard discussions about the human growth hormone and its relationship to health. And I’ve heard that stress depletes the hormone, while laughter supports the hormone [see http://www.hgh9.com/natural-hgh.html ]. Great! So here is something meant to make you smile and perhaps even laugh out loud.

Isn’t Mel a good reminder that life is such a balancing act?

October, 216, 2011

Here is my daughter behind the bullhorn coaching a college crew team. In the fall. On the water at Stone Mountain, Georgia. And there is her ‘firstborn’–a beloved black lab who goes everywhere she goes that it is at all possible for her to go.

My daughter is four months pregnant now. And she has given up coaching her college crew team. And she told me this weekend that Mel has become very protective. And she wonders how this will play out as the weeks and months go by.

I predict that Mel will continue to be as close as she can be to her beloved human. And that they will play out the balancing act that is life…together for many years.

Journey… isn’t that a great name for a dog?

October 11, 2011

There is a new member in the family. My grandkids have a new pet friend. Her name is Journey.

 And she reminds me of why kids and gentle big dogs go so well together. The dog is gonna get a lot of love… Something that comes through in this video as well.

http://www.angelfire.com/ak2/intelligencerreport/boy_dog.html

Weighing in — what’s the debate about Dr. Oz and the apple juice story really tell us?

September 21, 2011

All has been quiet on the talking about health front. I am in the midst of teaching the undergraduate class about designing health messages at Penn State, so it is odd that I don’t find my way here more often. But in the fury of the debate over the Dr. Oz show about apple juice. [go here to read and listen to the debate if you want more information: http://www.doctoroz.com/videos/arsenic-apple-juice], I had to make time to add a few thoughts.

First, in favor of Dr. Oz — his show entertains us and informs us at the same time. We do have to remember that someone has to pay the bills for the show, so the entertainment quality has to be there. It is that simple.

The positive things about a show like Dr. Oz is that it can arouse public passions about scientific issues and lead to health advocacy. It may increase healthy behaviors and improve our vocabulary when it comes to talking about health and the science of health.

But on the negative side–it can be confusing and contribute to inaccurate understanding. It may arouse public passions but these can be misdirected.

The apple juice show and related debate illustrates both. The headline for the page above and the text beneath illustrates this reality. What is an “extensive national study”? According to the text, it means “dozens of samples” from “three different cities”. That is neither extensive nor a nationally representative sample.

How was the study conducted? Even with the several dozen samples, there is much room for the approach to vary. Did the tester shake the apple juice before drawing a sample? That might be important in terms of how the contents in the apple juice are distributed through the liquid. Did the tester take a sample from the bottom of the juice container or the top? Did the tester take more than a single sample of juice from each of the containers tested? Inquiring minds want to know…

But instead of focusing on specific and direct questions to guide our understanding, the backlash focused on name-calling. Skimming the contents of various letters from companies represented on the show and the Food & Drug Administration–FDA–“irresponsible” might be the most frequently leveled charge. Dr. Besser calls the Dr. Oz show “fear-mongering”. Watch this exchange:

I give credit to Dr. Oz for remaining calm and answering the charges.

But I wanted to know more about organic and inorganic arsenic levels, and other issues such as I raised above. I wanted to know less about Dr. Besser’s “upset”…