Sunday, November 29, 2009

Medication Enhances Female Sexual Interest

This drug will be most welcome for low sexual desire and to counteract the side effect of SSRI anti-depressants.

" Nov. 13 (Bloomberg) -- Boehringer Ingelheim GmbH is banking on sex really being all in women’s heads.

The German drugmaker is putting the finishing touches on a pill designed to reawaken desire by blunting female inhibitions. Unlike Viagra, which targets the mechanics of sex by boosting blood flow to the penis, this drug works on the brain.

The desire drug, the focus of a meeting on sexual disorders in Lyon next week, has the potential to revolutionize sexual medicine much as Pfizer Inc.’s blue pill did a decade ago. That could put family-owned Boehringer at the center of a debate about whether the medicine is a chemical shortcut around a complex dysfunction involving body and mind -- or whether disinterest in sex is a legitimate medical condition.

“This drug has the potential to finally open the door to acceptance of the idea that decreased desire can be something that involves a dysfunctional way the brain works, and not only a bad partner,” said Jim Pfaus, a neurologist at Concordia University in Montreal, who conducted early tests of the drug in rats. “Of course it’s in your head.”

The U.S. market for medicines to rekindle female libido could be bigger than the $2 billion a year in U.S. sales for erectile dysfunction treatments because more women report sexual problems, BioSante Pharmaceuticals Inc. Chief Executive Officer Stephen Simes estimated last year."

Friday, November 27, 2009

Medical Malpractice Litigation Stress: What No One Will Tell the Doctor Victim of Lawsuit Abuse

There is an inherent conflict of interest of all parties in a case, save that of the jury. The jury is the sole friend of the innocent doctor. All others are backstabbing mortal enemies. The standard advice in this article is wrongheaded. The innocent defendant doctor has a moral duty to attack and to utterly destroy the other side, and to totally intimidate the insurance company and its running dog, the insurance defense lawyer. This is to protect clinical care from plunder by all sides. It is strongly recommended that the defendant doctor hire a private attorney to defend his interest against the insurance company and the defense lawyer it has hired on the cheap. The private attorney should get the instruction to show no mercy to the enemy.

Insurance Company. Even if doctor owned, its interests lay in churning litigation. The doctor officers get high salaries when lots of premiums are collected. They will oppose any measures that will deter the filing of weak claims.

Insurance Defense Attorney. This defense lawyer gets paid a tiny amount. It is impossible that it even covers overhead. The doctor will learn what it feels like to be an HMO patient, when he gets minimal legal care from this defense lawyer. The latter will always try to get to trial to just break even. He will refuse to file motions to dismiss. He will refuse to seek sanctions against the other side for their misconduct. He will refuse to go after a biased judge. That is where the private attorney comes in. If the doctor complains, he will be dismissed, as not knowing any law. If the private attorney, preferably specializing in legal malpractice speaks, the defense lawyer will take notice, and be less dismissive. The private attorney should repeatedly threaten to sue the defense lawyer in writing every time he refuses to be more aggressive in getting rid of the case.

Plaintiff Attorney. The doctor should read the Rules of Conduct of the state, covering the licensed lawyer. Every utterance that in the least hints at a violation should be reported to the Disciplinary Counsel. If he is licensed in multiple states, file one complaint a month. Prolong the period of investigation. If kept confidential, the complaints have legal immunity. They may be shared with the personal lawyer. Demand total e-discovery of the plaintiff lawyer, including all social network sites back to kindergarten. Try to get a hold of the personal and work computers. The justification is to search for an improper motive for the lawsuit. If child porn, any other shady activity, or prejudiced utterance is found, put into the public record. Report all child porn to the FBI. Try to destroy the life of the plaintiff attorney, just as he doing to the doctor.

Plaintiff. Demand total e-discovery, and deep background checks on the plaintiff and its family.

Plaintiffs are always boohooing on TV. It is unclear if adverse information about the plaintiff and the plaintiff lawyer should not be trumpeted in public. The lawyers say they advise against that because all statements will be used against the defendant at trial. That is an open question.

Plaintiff Experts. There is no recourse outside of the trial against the false testimony of the plaintiff expert. The defense lawyer will accept this person as it comes. No. The defendant is an expert himself, and that should be used. The defendant should read every word the plaintiff expert has ever uttered, in articles, in depositions. If the expert has little experience to offer, the private lawyer must force the insurance company defense lawyer to move to disqualify. If that cannot be done, read every word for contradictory statements to impeach the expert on the stand. The Golden Fleece of research on the plaintiff expert is the utterance of a false fact. Opinion cannot be verified nor contradicted, and is protected by the Free Speech Clause, and several Supreme Court decisions. The assertion of a false fact in any submitted document or testimony is perjury and a crime. Once found, a motion to declare a mistrial should be made, and all legal costs should be assessed to the private assets of the lying witness.


This article advises the standard advice of taking it in the rear quietly.

"Plaintiffs bringing medical liability cases commonly contend they have experienced pain and suffering. Many physicians could say the same about being dragged into the litigation process.

Karen Kohatsu, MD, a San Diego-area obstetrician-gynecologist, was confident she would prevail when she was sued a couple of years ago, but isolation and sleepless nights still reigned throughout the process. The suit was eventually dismissed.

"Self-doubting occurs when you read the summons and depositions from the other side," she said. "The other side makes it sound like you are a terrible person for missing a diagnosis. You feel really alone and have to turn everything inward because you don't have anyone to talk to about it."

Dr. Kohatsu is not alone.

Experts say litigation stress syndrome is a real phenomenon, and one that has a significant impact on physicians. Various emotions, including anger and depression, can strike, along with an inability to concentrate.

When physicians are counseled by their lawyers not to talk about the case, most take that to mean they can't talk about the experience at all, experts said. But increasingly liability insurers and professional medical societies are instituting programs designed to help physicians deal with the emotional rigors of litigation stress.

"In the big picture, we want to normalize the experience of litigation," said Ronald L. Hofeldt, MD, a psychiatrist in Salem, Ore. He serves as a consultant to medical liability insurers and other organizations, helping design retreats and wellness programs that give doctors a venue to air their litigation concerns and help them develop coping skills."

Thursday, November 26, 2009

Current State of Tarasoff Decision

Here is a database of state rules on the duty to warn.

This decision mandated the reporting of a person-specific threat by a mental patient to the target. It was more lawyer intimidation and take over of clinical care. I doubt a single life has been saved by this decision. The alternative is to rely on clinical judgment. There are 2000 people murdered by paranoid schizophrenics each year. The doctor should have the discretion to call the target, the police, the family of the patient, or to file commitment papers to maintain safety. All these remedies that could prevent harm have been closed off by the lawyer on the bench. The Tarasoff was irrational, then and now. It did generate multiple lawsuits and the plunder of clinical care, and that was its sole real purpose. From Daniel W. Shuman, JD. This article contains statutory reporting requirements by state.

"The case in brief

The plaintiffs in the lawsuit (Tarasoff v Regents of the University of California, 551 P2d 334 [Cal 1976]), the victim’s parents, alleged that a patient (Poddar) communicated his intention to kill their daughter to his therapist, but that the therapist neither warned her nor took other appropriate actions and sought damages for the resulting harm. The de-fendants moved to dismiss.

There are no new facts to add to the recitations found in hundreds of books and articles on Tarasoff, and nobody wants to hear them again. The trial transcript might have provided some new perspective, but there was no trial or evidentiary hearing. According to the Supreme Court of California, there had been a “Complaint” containing the claimants’ version of events. But instead of an “Answer,” which might have admitted or denied the factual allegations of the complaint, the defendants filed a “Motion to Dismiss,” which, according to convention, accepted the plaintiffs’ factual allegations for purposes of the motion only.

The court granted the motion to dismiss, and the plaintiffs took this appeal. No trial. No evidentiary hearings. And no evidence. The report of Poddar’s appeal of his second-degree murder conviction centers on his mental state and consequential culpability (People v Poddar, 103 Cal Rptr 84 [Cal Ct App 1972]). Although there are inherent limits in every case on accurately reconstructing the past, this case was resolved before an attempt to do so. The facts, therefore, that have been passed on from one article to the next may be right or may be urban legend. We do not know.

The legal ramifications

Why does it matter what the sources of the reported facts were anyway? Why should we care whether some came from a journalist, some from a paralegal who worked for the defendants, and some from the authors of the Tarasoff articles’ independent investigation?

First, we have an imperfect but known reliability filter called the “Rules of Evidence” to screen proof of facts in trial. We cannot endorse extra-judicial fact-finding without knowledge of the process and its reliability. Second, cognizant of the limitations of this fact-finding process, the judicial system is explicit about the standard of persuasion, which expresses the level of confidence required on an issue—probable cause, preponderance of the evidence, clear and convincing or beyond a reasonable doubt. Third, the legitimacy of the fact finder in our judicial system—jury or judge—is grounded in constitutional law and public scrutiny.

By what process were these “facts” determined? To what degree of certainty? By what authority? What are the implications for the scholarship perched on this precarious foundation? Before going any further, this is a conversation in which those authors who discovered or applied those facts should be included.

The opinion of the California high court recites the procedural history of the case.10 A civil claim for damages was brought in a California court in Alameda County, against a California university health center psychologist, among others. It alleged that in 1969, a student-patient of the psychologist murdered another student. In response, the defendants filed a motion to dismiss."

Monday, November 2, 2009

Illinois SC: No Duty to Wife of Patient

Paranoid schizophrenics kill about 2000 people a year. Current lawyer mandated commitment laws require an injury, rather than the need for treatment. The doctors thus cannot commit people, and has some duty to warn. This decision states there was no duty to the wife the patient killed, despite her involvement in his care. Other state courts would have held the doctors liable. Contrast this result to the cases in Massachusetts, where drivers with hypoglycemia and a brain tumor injured other drivers, and the doctors were found to have a duty to the third parties.

"Richard Street sought psychiatric treatment at Community Resource Center Inc. in 2003 after he reported thoughts that his wife was trying to poison him, court records said. Street told the doctors and hospital social workers caring for him that he planned to kill his wife, Teresa Street, and that he wanted to be admitted to a psychiatric facility. He changed his mind during the admitting process and returned home, while continuing his medication treatment.

Three days later, Richard Street was found lying over the body of his strangled wife. He ultimately pleaded guilty to murder and was sentenced to 18 years in prison, records show."