ABC's 'Private Practice' explores bioethics

Date: 9/30/2008 10:26 AM

By SANDY COHEN
AP Entertainment Writer

LOS ANGELES (AP) _ On a massive sound stage at Hollywood's Raleigh Studios, a woman is dying of ovarian cancer. One doctor wants to treat her traditionally, by removing her uterus and ovaries. Another wants the patient to participate in a clinical trail that might preserve her ability to have children, but could have serious side effects.

On a different day, an obstetrician is conflicted about whether to deliver a premature baby she believes was conceived solely because the umbilical-cord blood could save the family's older, dying child. Another doctor struggles to do what's right when his teenage patient — who has HIV but doesn't know it — confides that he plans to have sex for the first time.

Bioethical questions like these come up weekly on ABC's "Private Practice," the "Grey's Anatomy" spin-off that begins its second season Wednesday.

"We're telling stories ... that will provide a lot of moral debate among our doctors and maybe debate at home when you watch," said series creator Shonda Rhimes.

The issues they face cause plenty of drama for the doctors at the Oceanside Wellness Group, where Kate Walsh's character, Addison Montgomery, came to work after leaving "Grey's" Seattle Grace Hospital.

"They're all viable conflicts ... grounded in these medical stories," Walsh said. "It's topical but not so procedural that it's not a Shonda Rhimes show. You still have all the great dialogue and characters and stories and romance."

Like "Grey's Anatomy," ''Private Practice" features an ensemble cast of doctors whose personal lives are often far messier than their professional ones. They have affairs with one another and struggle with love as they overcome tough medical challenges and the financial realities of keeping their medical co-op alive.

The bioethical issues raised are based on real medical cases and community concerns, said researcher and writer Elizabeth Klaviter.

"We look at the things that have ourselves and our family members and friends buzzing — the issues that people are talking about in terms of right or wrong and the laws, ethics and social morays that are put on us in terms of how we conduct ourselves," said Klaviter, who also researches cases for "Grey's Anatomy."

"Doctors disagree," she said. "We're looking for cases where there are different courses of action or treatment."

This season, the doctors at Oceanside Wellness will have to decide what rights prostitutes have to medical care and whether to treat a sex offender at their child-friendly practice. They also engage in an abortion debate that surprised actor Tim Daly, who plays Dr. Pete Wilder.

"I never thought we'd be doing something like that on Disney," which owns ABC, he said. "It was just these characters discussing their opinions and they didn't agree and they were passionate about it, just like in the real world."

Daly and his castmates credit Rhimes and the show's writers for using the forum of a prime-time drama to inspire viewers to consider current bioethical issues.

"If you can make anybody think in this day and age, and entertain them at the same time, that's a dream come true," said KaDee Strickland, who plays Dr. Charlotte King, a physician at a rival hospital.

Making bioethics a theme of the show is "seductive," Walsh said, because it deepens the characters while raising important issues for viewers to ponder. Though she said it was a risk for her to leave "Grey's," she feels she landed in a good place.

"It was a risk but it wasn't like sex-without-a-condom risk. It was an offer I couldn't refuse," she said. "I'm hugely grateful that it did really well last fall... It's really a testament to Shonda and her gift for being able to tap into the culture and the big collective consciousness of what people really relate to."

History proves that viewers respond to medical shows: "We may never end up in a courtroom or never end up arrested, but sooner or later everybody's going to come through the doors of a doctor's office," Rhimes said. Exploring bioethics adds a new dimension to the already-beloved genre.

"It's something more and more doctors are facing these days," Rhimes said. "It's just a very different way of looking at medicine that I don't think we normally think about — the ethics of what you're doing."

ABC is owned by The Walt Disney Co.

Copyright 2008 The Associated Press.

Doctors: infection led to Turkish newborn deaths

Date: 9/22/2008 2:18 PM

By SUZAN FRASER
Associated Press Writer

ANKARA, Turkey (AP) _ An infection spread by IV treatment led to the weekend deaths of 13 premature newborns at a hospital in western Turkey, a doctor investigating the deaths told the private Dogan news agency Monday.

The deaths drove the number of babies killed by infections in Turkey to at least 40 in three months.

In July, more than 27 newborns died of an infection at a hospital for high-risk births in the capital, Ankara. Government-appointed doctors investigating the deaths said a staff shortage had increased the risk of infection.

Recep Ozturk, a doctor at Istanbul's Cerrahpasa University Hospital, said preliminary results indicated that IV-spread infection caused the latest deaths at Izmir's Tepecik hospital Saturday and early Sunday, Dogan reported. Ozturk, who spoke on behalf of the group of doctors investigating the case, said the infection appeared to be spread by intravenous solution, Dogan reported.

A local prosecutor was investigating whether neglect may have been a factor.

Izmir health department head Mehmet Ozkan said the hospital believed the babies were not neglected. Tepecik hospital was caring for 41 newborns overnight Saturday. After the 13 deaths, the unit was placed under quarantine and no new babies have been admitted. The hospital has 30 incubators and can accommodate 45 infants.

The bodies of three babies buried over the weekend were being exhumed to help with the investigation, the state-run Anatolia news agency reported.

Hospitals in small towns in Turkey generally lack specialized premature birth units, and high-risk or premature babies are often taken to larger hospitals in cities such Istanbul, Ankara or Izmir.

Health workers unions say, however, that the larger hospitals are often understaffed or ill-equipped to care for large numbers of newborns.

"These unfortunate deaths are very saddening," Prime Minister Recep Tayyip Erdogan said. "There may have been neglect, this will become clear after the investigation."

"Premature births constitute a high risk, and this may have played a part, too," he said.

Turkey's infant mortality rate is relatively high, at 23.66 in 1,000 in 2005, compared with that of its EU-member neighbor Greece, where 3.8 newborns out of 1,000 died the same year, according to the Organization for Economic Co-operation and Development.

Copyright 2008 The Associated Press.

Turkey investigates hospital deaths of 27 babies

Date: 8/4/2008 1:09 PM

By SUZAN FRASER
Associated Press Writer

ANKARA, Turkey (AP) _ Turkey's Health Ministry launched an investigation Monday into the deaths of more than two dozen newborn babies at a hospital in Ankara.

The Zekai Tahir Burak hospital has acknowledged that 27 babies died there in the past two weeks, but said most had died from complications related to premature delivery.

Most of the 26,000 babies born each year or admitted to Zekai Tahir Burak are premature, as the hospital handles high-risk births. The hospital could not immediately say how many babies were delivered in the two week period involving the 27 deaths.

Turkey's infant mortality rate in 2005 was 23.6 in 1,000, relatively high compared with neighboring Greece, where 3.8 in 1,000 newborns died the same year, according to the Organization for Economic Co-operation and Development.

But a health workers union said 27 recent deaths in two weeks at the state-run hospital in Ankara was too high, and blamed poor sanitary conditions and negligence.

Health Minister Recep Akdag ordered an inquiry into the deaths, and the ministry set up a team of investigators to look into practices at the hospital, which has one of the busiest maternity wards in the capital. The hospital says it has capacity for 122 newborns at a time, but often has up to 180.

The ministry said the results of the investigation would be made public.

"The necessary measures will be taken if anyone is found to be at fault," it said in a statement.

Over the weekend, Dr. Ugur Dilmen, who heads the hospital's newborn unit, said the babies' deaths were the result of birth defects, heart failure, hernia, hypertension and stillbirth.

The hospital said tests had ruled out infection as a possible cause.

"None of the deaths were caused by a hospital infection," chief physician Leyla Mollamahmutoglu said.

The Health and Social Services Workers union, however, questioned the hospital's sanitary conditions. Union chief Kemal Yilmaz said Monday that visitors entered the newborn unit with plastic booties over shoes, but no masks.

Yilmaz also suggested the hospital was understaffed and overcrowded, with up to three newborns placed in one incubator.

He demanded the hospital answer questions about how many babies each nurse is responsible for, and whether any of the babies who died had been given antibiotics, among other queries.

Copyright 2008 The Associated Press.

Pre-pregnancy diabetes tied to more birth defects

Date: 7/30/2008 12:01 AM

BC-MED--

By MIKE STOBBE
AP Medical Writer

ATLANTA (AP) _ Diabetic women who get pregnant are three to four times more likely to have a child with birth defects than other women, according to new government research.

The study is the largest of its kind, and provides the most detailed information to date on types of birth defects that befall the infants of diabetic mothers, including heart defects, missing kidneys and spine deformities.

The study lists nearly 40 types of birth defects found to be significantly more common in the infants of diabetic mothers than in those who weren't diabetic or who were diagnosed with diabetes after they became pregnant.

The study's list of diabetes-associated birth defects is surprising — it's much longer than was previously understood, said Janis Biermann, senior vice president for education and health promotion at the March of Dimes.

"It adds more information about the specific types of birth defects associated with pregestational diabetes and gestational diabetes," said Biermann, who was not involved in the research.

Researchers from the Centers for Disease Control and Prevention led the study, which is being published in the American Journal of Obstetrics and Gynecology. CDC officials released the study Wednesday.

Birth defects affect one in 33 babies born in the United States, and cause about one in five infant deaths. The cause of most birth defects isn't known but some risk factors include obesity, alcohol, smoking and infections.

Doctors have known for decades about the threat diabetes poses to pregnancies. Past research has focused on dangers to the infant by the extra amounts of glucose — sugar — circulating in the womb of a diabetic mother. Studies with rats and mice clearly show excess sugar harms fetal tissue development, said Dr. E. Albert Reece, a study co-author, who directs birth defects research at the University of Maryland School of Medicine.

The new study draws from the birth records between 1997 and 2003 at hospitals in 10 states — Arkansas, California, Georgia, Iowa, Massachusetts, New Jersey, New York, North Carolina, Texas and Utah.

The study focused on the 13,000 births involving a major birth defect, and compared them to nearly 5,000 randomly selected healthy births from the same locations.

Mothers were asked if they had been diagnosed with diabetes before or during their pregnancy. The researchers said those who were diagnosed while pregnant either had a temporary, pregnancy-induced condition called gestational diabetes or had diabetes that had gone undiagnosed until they were pregnant.

The study found that there was no diabetes involved in 93 percent of the birth defects.

About 2 percent of the children with single birth defects were born to mothers who had diabetes before they became pregnant. About 5 percent of the infants with multiple defects were born to mothers with that condition. In healthy births, the percentage of mothers who were diabetic before pregnancy was much lower.

The study also showed a wide range of birth defects that included malformation of the heart, spine, limbs and gastrointestinal tract.

"Diabetes is not discriminating" in which birth defects it's linked to, said Dr. Adolfo Correa, a CDC epidemiologist who was the study's lead author.

___

On the Net:

CDC: http://www.cdc.gov/ncbddd/bd/facts.htm

Copyright 2008 The Associated Press.

Child welfare worker charged in baby's death

7/2008 03:18 PM

By SUSAN HAIGH
Associated Press Writer

HARTFORD, Conn. (AP) _ An employee of the state Department of Children and Families has been charged in the death of a 7-month-old foster child in her care, prompting the agency to seek her dismissal.

State police charged Suzanne Listro, 40, of Mansfield, with manslaughter Wednesday in the May 19 death of Michael Brown Jr., who suffered a blunt trauma head injury at her home. At a court appearance Thursday, a judge set bond at $1 million.

"We don't expect her to be posting bond today," her attorney, Matthew Potter, said Thursday. He declined to comment further.

Listro, a children's services consultant for the department, received a foster care provider's license earlier this year, despite having been investigated twice within the past two years on allegations she abused another child she adopted, said the agency's commissioner, Susan Hamilton. The allegations were not substantiated.

Listro has been placed on unpaid leave, and Hamilton is seeking to have her fired.

The agency will start requiring an outside firm to review agency employees who want to be foster parents.

Hamilton said she also plans to dismiss a department investigator who handled the two previous abuse probes in 2006 and 2007 involving Listro and her adopted child. She called those investigations "substandard and unacceptable."

A manager who approved both investigations will be suspended for 20 days, Hamilton said.

Because the alleged abuse was unsubstantiated, Listro's name was not listed in the automated child abuse and neglect registry when she was being investigated for a foster care license, Hamilton said.

"Although it's impossible to determine whether this information would have changed the licensing decision, it's clear that it should have been easily accessible to the licensing staff," Hamilton said