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Life is Complicated – 4: The Wolf in Sheep’s Clothing

June 21st, 2016 by drcoplan

Wolf in Sheeps Clothing Milo Winter 1919

We began this thread in the aftermath of the Indiana State Legislature’s decision to remove disability in the offspring as a legal reason for termination of pregnancy Go here to read the full text of the legislation).

I asked readers for their opinion of what they would do if they were a doctor practicing in Indiana. This proved to be an overwhelming or unanswerable question. (In any case, I got no answers!). Then I rephrased the question: If you found yourself or your partner pregnant and the fetus had a genetic disorder, and you were planning to discuss the issue with your doctor, how would you like your doctor to treat you? My hope was that wording the question this way would make it more accessible – since everyone has been a patient at one time or another, and we all have expectations of how we’d like to be treated by the doctor.

I received an extended reply from a woman named Anne, who is the mother of a child with severe disabilities. Although Anne was prepared to accept abortion for various other reasons, she equated termination of pregnancy on the grounds of disability in the offspring with repudiating the value of her own living child with disabilities: “If people like [my son] can’t depend on their own mothers or on their [physicians] to defend, fiercely, their place in this world, then we’ve failed.”

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Autism, Ebola, and the Will Rogers Effect

October 28th, 2014 by drcoplan

 

ebola

Dr. Coplan reflects on the history of autism, as it may relate to the Ebola epidemic.

I’m going to take a risk this week, and put in my 2 cents on a topic that’s outside of my primary area of expertise – Ebola Virus. What can a Neurodevelopmental Pediatrician contribute to this conversation, and what do autism and Will Rogers have to do with it? Read on….

One of the terms you hear in connection with Ebola Virus (EV) is “Case Fatality Ratio” (CFR). CFR is defined as the number of infected persons who die divided by the total number of persons who are infected. (CFR = Deaths / Total Infected). This ratio is murky for various reasons.

The numerator is the easier value to discover: Death from Ebola is dramatic, and hard to miss. Even the numerator, however, is never 100% accurate: If you are living in the bush, and there are no healthcare workers to document your demise, your death may go uncounted. Or, in non-epidemic situations, an isolated death here or there, even in a medical setting, may go undiagnosed. But in epidemic settings, especially when healthcare workers are on the scene, the numerator can be tallied within a tolerable level of error.  Read the rest of this entry »

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