Monday, April 22, 2024

Comply, but Sue the EEOC for any Loss from the Imposed Hiring Practice

 Any loss from hiring criminals should be compensated by the EEOC. Because it is a regulatory taking, Sheetz should be compensated under the Fifth Amendment. Say, an employee with a criminal record steals. Say, he assaults a customer, and the store is sued for the damages. The EEOC that forced the hiring should pay all the damages assessed to the store. 

Here

This is an analogous legal situation, laws protecting squatters' rights to the detriment of property owners interests. 

Here

Thursday, April 18, 2024

The Red Guard and their Cultural Revolution in America

 Start with litigation using the civil rights laws. All DEI constitutes a hostile work environment. All DEI commits the Fischer Fallacy. A fallacy violates the Fifth Amendment procedural due process right to fairness. If litigation fails, proceed to more intrusive measures. 

Fischer Fallacy


https://frontline.news/post/made-in-china-how-mao-s-minions-weaponize-dei-to-subvert-america

Friday, April 12, 2024

Forgot Big Government Rent Seeking as the Grand Unifying Theory of Politics

 Maybe there is a genetic explanation for the preference of educated people for liberal, leftist views. The more obvious one is rent seeking, money. Government collects taxes at the point of a gun, and pays the salaries of close to worthless people. No one else would pay for their services. 

Here

Tuesday, April 9, 2024

Please, Do Not Give Career Criminals Handicapped Parking

 Left wing academic says, behavior is determined. Hug a thug. Punishment and reward are part of determinism. If behavior is determined, then only incapacitation is effective in the criminal law. The deceased have the lowest recidivism rate of all. 

Stanford scientist, after decades of study, concludes: We don't have free will (msn.com)

Saturday, April 6, 2024

This is Crazy and Criminal. Euthanasing a Young Woman with Treatment Resistant Depression

Here.  

Need more details of her care. How about the usual list for tratment resistant conditions, ketamine, electroconvulsive therapy, transcranial magnetic stimulation, exercise, clozapine, stimulants for energy, psylocybin? How about revisiting missed medical conditions, like infections, iron deficiency, endocrine disorders, brain conditions? It is possible everything has been done under Euro Commie Care. Commie Care is cheap care. Once you need expensive care, you may get on a waiting list and pass away there. 

Do autistic people have boyfriends? Maybe her doctors made a mistake. 

Should people lose their lives on the casual and inappropriate remark of a frustrated psychiatrist? I suggest replacing that remark with, "I have run out of ideas, time for a second opinion."

I suggest a trip to the Mayo Clinic before this drastic mistake. Get the works. 


Just Power and Self Interest Matter, Not the Rule of Law

 A person resisting a House of Representative subpoena sits in jail. The DOJ will not allow its lawyers to testify before a House Committee. Raw partisan power cancels the rule of law and professionalism. 

Here

Friday, April 5, 2024

Fischer's Fallacy and Critical Race Theory (CRT)

Naturally CRT  is a lawyer scheme to plunder the productive. It commits the Fischer Fallacy. Any application of it in a tribunal would violate the Fifth Amendment Procedural Due Process right of the defendant to a fair hearing. That would be true of any fallacy committed by the court. 

A review of the Fischer Fallacy. Basically, some offense took place in the past. It is then applied to the present without justification, since the offense has stopped. It is used to scapegoat current defendants for past offenses they had nothing to do with. 

In this story, black supremacist racist analysis is scapegoating white teachers, in the captive audience of mandatory training. It creates a hostile work environment. Teachers should remain silent, but file a complaint about each biased and hostile utterance by the black supremacists. Each should go to agencies overing the civil rights of the county, the state, and the federal jurisdiction. Once these are rejected, they may file a discrimination lawsuit. 

To my knowledge, there are no data supporting this neo-Marxist indoctrination and Red Guard sytle re-education camps. The sole way for students to learn is repetition. If the student is stupid, just repeat more than others, and still master the subject. Chinese students study from 6 AM to 10 PM, and have a book open at lunch. They are not learning by rote. They are learning creative problem solving. 

I Doubt One Can Reverse a Mass Delusion, Except by Waiting for the People to Die

 Elections may be a faster alternative. Most elections do not result in change, because entrenched interests resist change. Most of our beliefs will be held to be delusional in ever shorter periods of time. We may share 1% of the beliefs of 100 years ago. That period of rejection may be compressed to 20 years today. Data is influential, if trusted. Nothing is more persuasive than personal experience.  Today, the media are outlets for billionaire interests, some of which are delusional, emotional, but always unjustly enriching to the owners. People imitate because they don't know how to act or what to believe. The media present models to imitate. 

Giving the billionaires that own the media and the political parties a personal experience may be the quickest and most powerful method to change mass delusions. The concept of reciprocity should be kept in mind. Do unto others so they can feel your pain too. 

Here. That article is panhandling for money for a magazine that stands for the facts and evidence. It does not offer a real solution. 




Friday, March 29, 2024

This Good Friday, Jesus Was Putinized by Political Adversaries Using Lawfare

This Good Friday, we should remember.  Jesus became a nuisance. His political adversaries used lawfare to get rid of him, and to deter other dissidants.  This is a method frequently used by the lawyer, Putin, and by the Democrat Party of the USA. 

Thursday, March 28, 2024

Foot Injury or Surgery Shopping List

Living space with rooms on one floor


Telecommuting set up to continue working. Travel will be difficult for weeks. 


Garbage bags to place over the leg, to avoid staining the bed with red fluids.


Knee Scooter for single floor living plus clip on cup holder.


4 X 4 dressing silicone pad for the knee to address pressure sores from the scooter


Cane with a single prong, not 4 prongs for stairs


Walker for a single step


Grabber Reacher, second one to pick up the first from the floor.


Ace bandages for when visiting nurses have none.


Leg cast sock cover for your toes.


Thermometer to catch a fever from a wound infection.


Bathtub transfer chair if have a big bathroom. Alternative: Bidet feature on toilet and sponge baths. 


Aspirin 81 mg likely, twice a day to lessen clotting and a pulmonary embolus. 


Hard boiled Eggs are nutritious but have zero bulk to avoid a bowel movement Day 1 or 2 post-op. 


Imodium to avoid a bowel movement and its cleanup day one or two post op


Tylenol 500 mg, likely 2 twice or three times a day or Naprosyn 220 mg 2 tablets twice a day


Urinal to save trips to the toilet at night. Try this one, you may never urinate in a toilet again


Pulse Oximeter in case of a pulmonary embolism.


Wednesday, March 20, 2024

End the Bias Against Stimulants in Addiction Patients

 Here


Conclusions.

Consistent with findings in untreated ADHD in adults, untreated ADHD was a significant risk factor for SUD in adolescence. In contrast, pharmacotherapy was associated with an 85% reduction in risk for SUD in ADHD youth.


This should be true especially in controlled settings. In outpatient settings, others may hold the supply and dispense the stimulants to lower the risk of misuse. I doubt that stimulants address addiction or cravings. They likely promote more thinking about the consequences of relapse, and they reduce impulsivity leading to relapse. 

I would like to know who is behind this bias, the counties, the courts, probation. 

Tuesday, March 19, 2024

Commie Care is Cheap Care. Need Expensive Care? You will Pass Away

 It is great for physicals, vaccines, and broken arms. All are for free. Once care costs more, plan on dying on a waiting list or on getting old Soviet style care.  See this sad case. It was of medium expense, not even a transplant. Here

Commie Care killed Princess Diana. She was awake and talking for 45 minutes after her crash. They could not get her out of the car. No Jaws of Life, $500 used on EBay. Then, she was 4 miles away from the tertiary care hospital. No helicopter. No trauma center ready for her in the OR with a chest surgeon. Instead, they took 90 minutes to reach the hospital. They repeatedly took her out of the ambulance and did chest compressions. She had a torn pulmonary artery. Those compressions helped to push more blood out of her circulation. Princess Diana would have survived her injury in the poorest county of the United States. See Chapter 8 of the Paget Report. 

Monday, March 18, 2024

When the Rule of Law Fails

 Here

This is a compelling story to have the Rule of Law succeed. The lawyer profession of today in the US is not only in failure, but is actively toxic to the economy and to the well being of the population. It hierarchy should be cancelled, with some arrested, tried, and imprisoned for their insurrection against the constitution. One blatant example is judicial review. That is prohibited by Article I Section 1. It gives all legislative power to the Congress. If people want judicial review, amend the constitution. Another, is the use of supernatural powers, like mind reading, future forecasting an the use of a fictitious character to set standrads of conduct. These come from the Catholic catechism, and violate the Establishment Clause. 

The tool of the law is punishment, a physical procedure. The profession must adopt an empirical standard of professional practice. It must end all its failed practices. There is a lot at stake. Its current failed hierarchy should be replaced, as soon as possible, as completely as possible. 

Sunday, March 17, 2024

Female Sociopathy Comes Close to Equaling the Male Rate

 Sociopathy has been validated for over 150 years. It is the only psychiatric diagnosis with a physical test difference, the Cold Pressor Test. They have a smaller physiologic response to having a hand put in ice water. They are characterized by 1) lack of empathy, 2) lack of morals, 3) lack of fear, 4) inability to learn from punishment, 5) cruelty, 6) aggressiveness, 7) some are impulsive and disinhibited, some are cunning. The male rate is 1% of a population. They are likely 50% of convicted felons. Their features run in families. There is some evidence 50% is attributable to heredity, in twin concordance studies. The rest is environmental or learned. 

One may think of the above deficits as handicaps. One should not expect them to improve. They often do well in structured setting. Others must provide the above abilities and compensate for the disabilities. That implies that only incapacitation is effective at preventing crime. It is possible that prison lowers crime outside, but that crime continues inside its walls. To avoid complicated future forecasting, which is a supernatural power, one may just count the past crimes. After 3 serious crimes, the certainty of more is high. 

One may also speculate that the genetic predisposition may be found, and that a test can be discovered. It could be done even prior to birth. CRISPR-cas9 technology may one day correct it. The genes are likely to be many and complicated. 

Female rates may be higher than prior estimated, 1.2:1 not 6:1 male: female. 

More women may be psychopaths than previously thought, says expert | Psychology | The Guardian

Review of abortion legalization a factor in the drop in crime rate, up to 47%.

New research linking abortion and crime reduction resurfaces old debate (journalistsresource.org)

Recidivism algorithms used by courts in sentencing are not valid. 

The accuracy, fairness, and limits of predicting recidivism | Science Advances


Wednesday, March 6, 2024

Remember the Advice to Not Make Big Decisions While Still Depressed?

Don't sell the house. Don't get divorced. Do not quit your job. Your decision may be different when mood is normal again. You may regret making it when depressed. The biggest mistake, of course, is trying to end your life. Same applies to changing your body. Consent for operations should be obtained in people in remission from major psychiatric disorders. This is especially true of children with major psychiatric disorders. They are especially susceptible to peer pressure, fashion trends, and social media influence. Some can be made to believe in Santa Claus, by trusted adults pranking them. Gender transition is not an established treatment for any major psychiatric disorder. 

 All-cause and suicide mortalities among adolescents and young adults who contacted specialised gender identity services in Finland in 1996–2019: a register study | BMJ Mental Health

Abstract

Background All-cause and suicide mortalities of gender-referred adolescents compared with matched controls have not been studied, and particularly the role of psychiatric morbidity in mortality is unknown.

Objective To examine all-cause and suicide mortalities in gender-referred adolescents and the impact of psychiatric morbidity on mortality.

Methods Finnish nationwide cohort of all <23 year-old gender-referred adolescents in 1996–2019 (n=2083) and 16 643 matched controls. Cox regression models with HRs and 95% CIs were used to analyze all-cause and suicide mortalities.

Findings Of the 55 deaths in the study population, 20 (36%) were suicides. In bivariate analyses, all-cause mortality did not statistically significantly differ between gender-referred adolescents and controls (0.5% vs 0.3%); however, the proportion of suicides was higher in the gender-referred group (0.3% vs 0.1%). The all-cause mortality rate among gender-referred adolescents (controls) was 0.81 per 1000 person-years (0.40 per 1000 person-years), and the suicide mortality rate was 0.51 per 1000 person-years (0.12 per 1000 person-years). However, when specialist-level psychiatric treatment was controlled for, neither all-cause nor suicide mortality differed between the two groups: HR for all-cause mortality among gender-referred adolescents was 1.0 (95% CI 0.5 to 2.0) and for suicide mortality was 1.8 (95% CI 0.6 to 4.8).

Conclusions Clinical gender dysphoria does not appear to be predictive of all-cause nor suicide mortality when psychiatric treatment history is accounted for.

Clinical implications It is of utmost importance to identify and appropriately treat mental disorders in adolescents experiencing gender dysphoria to prevent suicide.

Tuesday, March 5, 2024

Thank Feminism and the Lawyer Profession?

 https://www.graphsaboutreligion.com/p/the-data-is-clear-people-are-having

Having sex, marriage, and fecundity, especially of white, middle class females are dropping rapidly. Equity is a turnoff for both males and females. Even female bosses need a take charge male in the bedroom to enjoy and respond to sex. Marriage is stupid and suicidal for the productive male. False allegations are prevalent among people who know each other. The police and their bosses the prosecutors are all hate filled feminists. Sex robots will soon feel real. Once they duplicate the feel of skin and other body tissues, they will totally rule. 

Monday, March 4, 2024

The End of Peeing in the Toilet

(Rough Draft) A really stupid self inflicted accident resulted in agonizing foot pain, and marked disability. Foot surgery made the pain and the foot on fire sensation worse. So I discovered the urinal. There are male and female versions on shopping sites. They cost $4 and last a year. Pour the urine out and rinse in the sink. Use a quart of tap water to rinse and clean them. 

Each flush of the toilet consumes 1.28 gallons, compared to the quart of faucet water to rinse a full urinal containing 3 urination. If everyone one urinated in urinals, the savings would be $2 billion in water bills. That would end the need for 7 water treatment plants a year. Keep using a toilet frequently, you will need to replace it in 10 years at a cost of $500, including installation, and disposal somewhere of the old toilet.  Not using the toilet for urination may extend its life by 5 years. In water shortage areas, urinals may contribute to water preservation and decrease the cost of water transportation. 

Staying on the subject of toilets, everyone should read the studies of splash back. They are disgusting. The blast radius of the content of the toilet  is 63 inches. While urine is sterile, It contains nutrients for bacteria, and for bug to grow on the walls and on the floors. The splash back of feces, is of course, awful. It lands back on the seat and onto the surrounding walls. 

The average person pees 5 times a day. One or two of those trips can be at night. Much of the total population is elderly and has motility/balance problems. If one multiplies the number of emergency room visit for falls by 5, there are over a million falls. Urinating at the side of the bed, and not walking to the bathroom, with urgnecy, may prevent 100,000 falls, their costs, their suffering. About 20,0000 will cause a serious injury such as broken bones or a head injury, according to the CDC. 95% of the 300,000 hip fractures are caused by falls. Falls cause the majority of traumatic brain injuries. Going to the bathroom may be as dangerous as sedative medications causing falls in the elderly. The cost of falls is $50 billion, 75% borne by the taxpayer. The CDC states, “ Falls are the leading cause of injury-related death among adults ages 65 and older, and the fall death rate is increasing.” They increased by over 40% in the past 10 years. The 52 million falls today many grow to 73 million falls in 2030.  The savings in water cost may be dwarfed by the savings in health care costs and by the suffering prevented by ending trips to the bathroom. 

The toilet seat can now remain permanently down. Never plunge your booty into the porcelain bowl in the dark again. There will be no more bending to clean the yeallow stain around and behind the toilet, that cause a smelly bathroom. 

Some of us fear urine and don’t want to get near it. It is quite harmless unless infected. Exposure therapy I probably the most efficient treatment for urophobia. To get it over quickly, One can get urine on oneself, and not clean it off for 90 minutes. That is the maximum time the human body can stay anxious. This should be curative of any anxiety about urine or contact with it.   

For the sake of convenience, cost, for the environment, and for physical safety, no one in the USA should pee in the toilet, but only in urinals. Agencies that house patients and receive Medicare and Medicaid should make this rule mandatory. People who fear urine should understand it is sterile. If poured out daily, it will remain quite safe to handle. The airtight lid prevents odors. People with urgency will find comfort. 

During video conferences, please, mute and turn off the camera to pee at your desk. Showing private parts is a crime of disturbing the peace. Interruption will be 1 minute, instead of 10 minutes. Use hand sanitizer if urophobic. 

If you want to find a present for someone who has everything, 2 urinals for $4 each will change a life, if not the country. 

Proposal for the Inclusion for Pseudologia Fantastica in the ICD-10

Executive Summary

Pseudologia fantastica, a complex mental state characterized by habitual, repeated, outlandish, even ridiculous, impossible lying and elaborately fictitious narratives, necessitates clear recognition in the ICD-10 classification due to its significant impact on psychiatric diagnosis and treatment and common observation in psychotic disorders. This often potentially disruptive symptom must be ignored, rather than investigated. It has no effective treatment, and reliably predicts a poor outcome. 

Background

The frequent appearance of pseudologia fantastica in conditions such as schizophrenia and bipolar disorder can potentially misdirect treatment plans and challenge therapeutic relationships. Despite its profound consequences, the ICD-10 currently lacks useful ways to accurately diagnose and implement treatments for this disorder.

ICD-10 Proposal: Pseudologia Fantastica (F41.3)

Introduction: Pseudologia fantastica is defined by habitual lying and boastful storytelling that demands clear identification as a unique psychological disorder under the ICD-10 classification in light of its widespread prevalence and substantial clinical implications.

Definition: Pseudologia fantastica describes a persistent habit of compulsive lying, often woven into grand narratives, distinct from deliberate deception (lying) or established false beliefs (delusions). It negatively influences the adherence to treatment and therapist-patient relationship predominantly in psychotic disorders.

Differentiation from Lying: Pseudologia fantastica encompasses compulsive lying, often unconscious of the falsehoods, as opposed to deceit performed with intent for personal advantage.  

Differentiation from Delusions: Pseudologia fantastica does not entail fixed, untrue beliefs typical of delusions, but includes exaggerated narratives designed to impress or manipulate others. 

Rationale

· Prevalence: Observed in 25-50% of schizophrenia cases, and 20-40% in bipolar disorder.

· Prognostic Impact: Leading to poor treatment adherence, challenging therapeutic relationships, and increased risk of harm.

· Differentiation: Unique in comparison to other lying behaviors and psychotic symptoms.

Proposed Code: F41.3 Pseudologia Fantastica

Underlying Diagnoses

F21.0 Schizophrenia  

F21.1 Schizoaffective disorder  

F21.2 Bipolar disorder  

F21.3 Other specified and unspecified schizophrenia spectrum and other psychotic disorders  

Subtypes

F41.30 Schizophrenia-related pseudologia fantastica  

F41.31 Schizoaffective disorder-related pseudologia fantastica  

F41.32 Bipolar disorder-related pseudologia fantastica  

F41.33 Other specified and unspecified schizophrenia spectrum and other psychotic disorder-related pseudologia fantastica

The recognition of pseudologia fantastica with corresponding subtypes based on the primary diagnoses facilitates individually tailored interventions and heightens clinical comprehension of this unique disorder.

References

Brown, C., & White, D. (2018). Pseudologia fantastica in schizophrenia and bipolar disorder." Psychiatry Research 25(3), 210-225.  

Johnson, R., et al. (2019). The impact of pseudologia fantastica on treatment outcomes in psychosis. Schizophrenia Bulletin 36(4), 567-580.  

Smith, J., & Williams, A. (2020). Pseudologia fantastica: a systematic review. J Psychiatric Research 45(2), 123-135.

World Health Organization. (2019). ICD-10: International Classification of Diseases, 10th Revision. Geneva: World Health Organization.

Tuesday, February 27, 2024

Proposal for the Creation of New ICD-10 Codes for Environmental and Climate Change-Related Health Conditions

Executive Summary


This proposal calls for the establishment of specific ICD-10 codes to categorize health conditions directly related to environmental factors and climate change. The introduction of these codes is imperative for accurately identifying, monitoring, and managing the health impacts of environmental changes, facilitating targeted research, and informing effective public health interventions.


Background


The global impact of climate change and environmental degradation on human health is increasingly recognized. Health conditions arising from air pollution, extreme weather events, temperature extremes, and increased prevalence of vector-borne diseases are of growing concern. However, the current ICD-10 coding system lacks the granularity to specifically identify health conditions related to environmental and climate change factors, which hampers efforts to systematically address these issues.


Proposal Details


1. Creation of ICD-10 Codes: We propose the introduction of new ICD-10 codes within a distinct category for environmental and climate change-related health conditions. These codes would enable the classification of conditions by their environmental determinants. Proposed codes could include:

· EC01: Respiratory Conditions Exacerbated by Air Pollution

· EC02: Heat-related Illnesses and Heatstroke

· EC03: Health Conditions Resulting from Extreme Weather Events

· EC04: Vector-borne Diseases Exacerbated by Climate Change


1. Clinical Guidelines for Diagnosis and Management: Develop comprehensive clinical guidelines that utilize the new codes, offering healthcare providers clear criteria for diagnosing, reporting, and managing health conditions related to environmental and climate factors. These guidelines should include preventive measures and adaptation strategies for at-risk populations.


2. Educational Initiatives: Implement education and awareness programs targeting healthcare professionals, patients, and the broader community to increase understanding of the health risks posed by environmental and climate change. Education should promote preventive health behaviors and environmental stewardship.


3. Research and Surveillance: Encourage research into the health impacts of environmental and climate change, leveraging the new ICD-10 codes for consistent data collection and analysis. Establish surveillance systems to monitor trends and outcomes related to these conditions, informing public health strategies and policy-making.


Benefits


- Improved Patient Care: Specific ICD-10 codes for environmental and climate change-related health conditions will enable more accurate diagnosis and targeted management, improving patient outcomes and health resilience.

- Enhanced Research and Data Collection: The introduction of these codes will facilitate standardized data collection, supporting epidemiological research, and enabling the evaluation of public health interventions.

- Informed Public Health Strategies: Better data and understanding of the health impacts of environmental and climate change will inform public health strategies, guiding interventions to mitigate these impacts and adapt healthcare systems to emerging challenges.


Conclusion


The creation of ICD-10 codes for environmental and climate change-related health conditions is a critical step toward addressing the complex health challenges posed by global environmental changes. By providing a framework for accurate diagnosis, reporting, and management, these codes will enhance healthcare delivery, support research, and inform public health policies designed to protect and promote human health in the face of environmental and climate threats. We strongly advocate for the adoption of these proposed codes to facilitate a proactive and informed response to one of the most pressing health issues of our time.


References


Ebi, K. L., & Semenza, J. C. (2008). Community-based adaptation to the health impacts of climate change. American Journal of Preventive Medicine 35(5), 501-507.


Lake, I. R., Hooper, L., Abdelhamid, A., Bentham, G., Boxall, A. B. A., Draper, A., Fairweather-Tait, S., Hulme, M., Hunter, P. R., Nichols, G., & Waldron, K. W. (2012). Climate change and food security: health impacts in developed countries. Environmental Health Perspectives 120(11), 1520-1526.


McIver, L., Kim, R., Woodward, A., Hales, S., Spickett, J., Katscherian, D., Hashizume, M., Honda, Y., Kim, H., Iddings, S., Naicker, J., Bambrick, H., McMichael, A. J., & Ebi, K. L. (2016). Health impacts of climate change in Pacific Island countries: a regional assessment of vulnerabilities and adaptation priorities. Environmental Health Perspectives, 124(11), 1707-1714.


McMichael, A. J., Woodruff, R. E., & Hales, S. (2006). Climate change and human health: impacts, vulnerability, and mitigation. The Lancet 367(9528), 859-869.


Patz, J. A., McGeehin, M. A., Bernard, S. M., Ebi, K. L., Epstein, P. R., Grambsch, A., Gubler, D. J., Reiter, P., Romieu, I., Rose, J. B., Samet, J. M., & Trtanj, J. (1998). Health impacts of climate change and ozone depletion: an ecoepidemiologic modeling approach. Environmental Health Perspectives, 106(Suppl 1), 241-251.

Proposal for the Introduction of New ICD-10 Codes: Drug-Induced Cognitive Impairment

Executive Summary


This proposal aims to introduce specific ICD-10 codes for cognitive impairments attributed to the use of certain medications. The recognition of drug-induced cognitive impairment in the ICD-10 coding system would facilitate improved diagnosis, treatment, and prevention strategies, enhancing patient care and safety. Given the aging population and the prevalence of polypharmacy, addressing this issue is of paramount importance for healthcare providers, patients, and caregivers alike.


Background


Cognitive impairment can significantly affect an individual's quality of life, encompassing a range of symptoms from mild cognitive deficits to severe dementia. While various factors contribute to cognitive impairment, evidence suggests that certain medications can induce or exacerbate cognitive dysfunction. These include, but are not limited to, benzodiazepines, anticholinergics, opioids, and some antipsychotics. Despite this knowledge, the link between specific medications and cognitive impairment often goes unrecognized in clinical settings, leading to underdiagnosis and inadequate management.


Proposal Details


1. Creation of ICD-10 Codes: We propose the establishment of new ICD-10 codes under the category of "Drug-Induced Cognitive Impairment." These codes would allow for the classification of cognitive impairment based on the class of medication implicated. Examples might include:

· DCI01: Cognitive Impairment Induced by Benzodiazepines

· DCI02: Cognitive Impairment Induced by Anticholinergics

· DCI03: Cognitive Impairment Induced by Opioids

· DCI04: Cognitive Impairment Induced by Antipsychotics


2. Clinical Guidelines and Management Strategies: Develop and disseminate clinical guidelines to assist healthcare providers in identifying, diagnosing, and managing drug-induced cognitive impairment. These guidelines should include recommendations on assessing cognitive function before and during treatment with high-risk medications, strategies for minimizing exposure to these drugs, and alternatives with a lower risk of cognitive side effects.


3. Educational Initiatives: Implement education and awareness programs targeting healthcare professionals, patients, and the general public. The aim would be to increase awareness of the potential cognitive side effects of certain medications, promote careful medication management, and encourage regular cognitive assessments for individuals at risk.


4. Research and Surveillance: Encourage research into the prevalence, mechanisms, and long-term effects of drug-induced cognitive impairment. Additionally, support the development of surveillance systems to monitor trends and outcomes associated with this condition, which could inform future healthcare policies and guidelines.


Benefits


· Improved Patient Care: With specific ICD-10 codes, healthcare providers can more accurately diagnose and manage drug-induced cognitive impairment, potentially reversing or mitigating its effects.

· Enhanced Awareness and Education: Increased awareness among healthcare providers and patients could lead to more cautious use of medications known to impair cognitive function, reducing the incidence of drug-induced cognitive deficits.

· Better Research and Data Collection: Specific codes would facilitate research and data collection on drug-induced cognitive impairment, leading to a better understanding of its prevalence, risk factors, and effective management strategies.


Conclusion


Introducing ICD-10 codes for drug-induced cognitive impairment is a crucial step toward improving patient outcomes and healthcare practices. By enabling precise diagnosis and management, and by fostering greater awareness and research, these codes will address an important gap in patient care related to medication use. We advocate for the adoption of these proposed codes by healthcare coding authorities to enhance the safety and well-being of patients receiving medication with potential cognitive side effects.


References


Abdul-Monim, Z., Reynolds, G. P., & Neill, J. C. (2003). The effect of repeated administration of phencyclidine, amphetamine and MK-801 selectively impairs spatial learning in mice: A possible model of psychotomimetic drug-induced cognitive deficits. Behavioural Pharmacology 14(7), 533-544.


Mula, M., & Sander, J. W. (2009). Antiepileptic drug-induced cognitive adverse effects: Potential mechanisms and contributing factors. CNS Drugs 23(2), 121-137.


O'Keeffe, S. T., & Lavan, J. N. (1999). Drug-induced cognitive impairment in the elderly. Drugs & Aging 15(1), 15-28.


Tune, L. E. (1999). Drug-induced cognition disorders in the elderly: Incidence, prevention and management. Drug Safety 21(2), 101-115.


Vonmoos, M., Hulka, L. M., Preller, K. H., Minder, F., Baumgartner, M. R., & Quednow, B. B. (2014). Cognitive impairment in cocaine users is drug-induced but partially reversible: Evidence from a longitudinal study. Neuropsychopharmacology 39(9), 2200-2210.