A Short History of Medical Ethics

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Oxford University Press, USA, 2000 - Medical - 153 pages
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A physician says, "I have an ethical obligation never to cause the death of a patient," another responds, "My ethical obligation is to relieve pain even if the patient dies." The current argument over the role of physicians in assisting patients to die constantly refers to the ethical duties of the profession. References to the Hippocratic Oath are often heard. Many modern problems, from assisted suicide to accessible health care, raise questions about the traditional ethics of medicine and the medical profession. However, few know what the traditional ethics are and how they came into being. This book provides a brief tour of the complex story of medical ethics evolved over centuries in both Western and Eastern culture. It sets this story in the social and cultural contexts in which the work of healing was practiced and suggests that, behind the many different perceptions about the ethical duties of physicians, certain themes appear constantly, and may be relevant to modern debates. The book begins with the Hippocratic medicine of ancient Greece, moves through the Middle Ages, Renaissance and Enlightenment in Europe, and the long history of Indian 7nd Chinese medicine, ending as the problems raised modern medical science and technology challenge the settled ethics of the long tradition.
 

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Punyamurtula Kishore MD a.k.a. MAD DOG MILLIONAIRE , Brookline Doctor Pleads Guilty, Sentenced to Jail and Ordered to Pay $9.3 Million for Running
Medicaid Kickback and False Billing Scheme
Punyamurtula Kishore MD a.k.a. MAD DOG MILLIONAIRE to Surrender Medical License, Sentenced to House of Correction
BOSTON – A Brookline doctor has pleaded guilty, was
sentenced to jail, and has been ordered to pay $9.3 million in
restitution for running an intricate Medicaid fraud scheme involving
millions of dollars in taxpayer funds, Attorney General Maura Healey
announced today.
Dr. Punyamurtula Kishore, 64, along with his company Preventive
Medicine Associates, Inc. (PMA), pleaded guilty on Monday in Suffolk
Superior Court. PMA pleaded guilty to charges of Medicaid Kickbacks (8
counts), Medicaid False Claims (19 counts) and Larceny over $250 (11
counts). Dr. Kishore pleaded guilty to one count of Larceny over $250.
“Dr. Kishore orchestrated a complex kickback scheme to funnel a
lucrative drug screening business to his laboratories and then billed
taxpayers millions of dollars for those services,” AG Healey said. “This
case exhibited blatant theft of state funds that were supposed to go
toward care for some of our most vulnerable residents. This is fraud
that undermines the integrity of our health care system.”
Today, Superior Court Judge Janet Sanders sentenced Kishore to 360
days in the House of Correction, with 11 months to serve and the balance
suspended for 10 years. As a condition to his sentence, Kishore has
also agreed to surrender his medical license. Judge Sanders also ordered
Kishore and PMA to pay, jointly and severally, a total of $9.3 million
in restitution.
Dr. Kishore previously owned and managed PMA, a network of 29 medical
branches throughout Massachusetts, including physician office
laboratories and one independent clinical laboratory. Based on the AG’s
investigation, Dr. Kishore used bribes, or kickbacks, to induce sober
house owners to send their residents’ urine drug screening business to
his laboratories for testing. Residents were typically screened three
times per week.
A urine drug screen may be billed to MassHealth by a physician if the
screen is medically necessary. Drug screens generally are billed to the
MassHealth program for approximately $100 to $200. Dr. Kishore
manipulated his business relationships with sober house owners to
illegally obtain tens of thousands of drug screens paid for by
MassHealth for sober house residents who were never treated by PMA
providers.
In September 2011, Dr. Kishore and PMA were indicted,
and individually charged with Medicaid Kickbacks (8 counts), and
Medicaid False Claims (8 counts). In November 2013, Dr. Kishore and PMA
were indicted on additional charges of Medicaid False Claims (11 counts)
and Larceny over $250 (11 counts) for billing MassHealth for millions
of dollars in drug screens using the names of PMA physicians and nurse
practitioners who were not actually treating the patients or determining
the drug screens to be medically necessary. State regulations require
that the services must be medically necessary and the provider must be
physically present and actively involved in the treatment of the
member.
Two other individuals previously pleaded guilty to one count of
Medicaid Kickbacks in connection with their involvement in Dr. Kishore’s
scheme to defraud MassHealth. In June 2012, Damion Smith, 42, of New
Jersey, president of Fresh Start Recovery Coalition, was sentenced to
two years in the House of Correction suspended for two years with
probation. Carl Smith, 69, of Dorchester, manager of New Horizon House,
pleaded guilty in January 2015 and was sentenced to two years in the
House of Correction suspended for two years with probation.
The case against Thomas Leonard of Malden, the part owner and manager
of the Marshall House, a sober house located in Malden, is ongoing.
John Coughlin of Carver, president of Gianna’s House Inc., which
operates several sober houses located in
 

Selected pages

Contents

Fifth to Fourteenth Centuries CE
13
3 Medical Ethics of India and China
27
Fourteenth to Eighteenth Centuries
43
Eighteenth and Nineteenth Centuries
57
6 Ethics in American Medicine
63
Science Competence and Ethics
81
1940s to 1980s
99
From Medical Ethics to Bioethics
115
Notes
121
Index
149
Copyright

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About the author (2000)

Albert Jonsen, Ph.D. is Professor Emeritus of Ethics in Medicine, School of Medicine, University of Washington.

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