Medical ethicist Art Caplan joined BPR for his regular Wednesday segment, "Ask the Ethicist." Caplan is head of the division of medical ethics at NYU's Langone Medical Center, and cohost of the Everyday Ethics podcast. He talked about political candidates' medical assertions, celebrities' medical assertions, and employer-incentivized plans to live healthy lives.
The questions are below are paraphrased, and Caplan's responses are edited where noted [...].
Republican presidential candidate Donald Trump wrote recently that "tremendous infectious disease is pouring across our border." Is that true?
No, it isn't true. People are not bringing infectious disease from Mexico into the US. [...] The only place you really get outbreaks of infectious disease [...] is when we institutionalize people at the border and hold them for months without [good] hygiene. [...] I'm sure they're not in great shape at the end [of that]. The vaccination rate in Mexico is higher than some communities in the US! So, if you really wanted to avoid outbreaks of infectious disease you should stay out of Marin County.
During last year's Ebola scare there were unsubstantiated rumors that individuals could or would bring infectious disease across the US-Mexico border. There was even talk about a possible ISIS plan to do so. The CDC came forward and basically shot down those rumors. Should something similar happen here?
I haven't seen a similar thing here. I'm just wondering, [...] is the government more reluctant to speak up because they think it's in the middle of a political campaign? They don't want to take sides?
Was that Ebola thing even feasible, coming across the Mexico border?
Coming across the desert in a two-week trip, I'm pretty sure you'd be dead before you got here.
Actor Jim Carrey recently took to Twitter to denounce a law California enacted that tightened exemptions for vaccinations. What do you think about his activism?
Jim Carrey doesn't know anything about vaccines. He continues to spread the autism link, which is just bogus. [...] Jim Carrey-type statements prevent us from looking at other things because they keep making people want to go back and examine [it].
Sarah Palin famously made political hay by claiming Obamacare would institute "death panels," essentially groups of middle-managers who decided how to mete out care to patients. Where does that land on your ethical radar?
It's harder to be stupider than Donald Trump. [...] Of course you want people to talk about end-of-life care with their doctors. [...] Some of us want to die at home, some of us want to go to the hospital, etc. [...] These are all part of reasonable [...] planning, and you doctor can help you!
'There's only one death panel, and it's some guy with a white beard up in the sky.'
Palin seemed to say that they'd make the decisions for patients, rather than with them.
Scare-mongers and worry-warts were saying, 'even to bring this up, it's a death panel!' [...] There's only one death panel, and it's some guy with a white beard up in the sky. [...] We all think we can kale and alfalfa our way to an eternal existence, but that's not so. [...] This would just set up a little more incentive and say, 'here's a little bit of money, some time, go through this and check the boxes.' [...] If you don't want to do it, don't do it!
What do you make of employer-incentivized programs to get employees to stop smoking, exercise more, and live more healthily?
People usually say, 'Well, I'm gonna give you an extra three bucks a week to stop smoking.' Well, to stop smoking you really need to give 100 bucks. [...] The fiscal incentives [need to be] pretty big to get you to stop doing fun stuff.
But do they work? What are the drawbacks to employers offering this kind of thing?
How much do you want them getting into the lifestyle-you-lead issue?
It may create privacy issues. But the tradeoff is that everybody ends up saving money, especially insurance companies.
Yep, you definitely will save money. [If an insurer] can get you to not wear a motorcycle helmet, and do things that will kill you when you're very young, [they'll] probably save money. [...] So, presuming we all think that's insane, the next best [plan] is, live healthy.
The pharmacy chain CVS made headlines for ending tobacco sales in stores. Now they're withdrawing from the US Chamber of Commerce because the group has lobbied globally against anti-smoking efforts. Is this a big deal?
It is a big deal. You know, one of the ways big tobacco has survived and flourished is to export cigarette smoking and tobacco to other countries. [...] Internationally, the Chamber of Commerce, this business organization, lobbies against efforts to restrict smoking. [...] They fight that stuff overseas. So CVS said, we won't play ball with that. [...] You know what I say? Good.
>>Art Caplan joins BPR every Wednesday for "Ask the Ethicist."
