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Michael A Grodin

Publications and source records attributed to Michael A Grodin.

13 recordsLinked to original sources
PubMed2006

Characteristics and utilization of primary care services in a torture rehabilitation center.

We conducted a retrospective chart review to look into the utilization of healthcare services of refugees. Between December 1998 and June 2001, 146 refugees received care at the Boston Center for Refugee Health and Human Rights. The mean age was 39+/- 1 years; 57% were males, and 84% were survivors of torture. A significant number of patients were diagnosed with major depression (70%), post-traumatic stress disorder (58%), past hepatitis A infection (77%), and tuberculosis classes 2 and 3 (42%). Patients had on average 2.3 +/- 0.1 initial health assessments visits and 3.6 +/- 0.3 primary care follow-up visits during a mean follow-up period of 12.8 +/- 0.8 months. Subjects with two or fewer initial health assessment visits were less likely to be undergoing psychological counseling (OR: 0.22; 95% CI:0.08-0.58), less likely to be seeking asylum (OR: 0.16; 95% CI: 0.06-0.43), and more likely to be self-referred (OR: 9.6; 95% CI:2.4-39.6). Four or fewer primary care follow-up visits were more likely in subjects who had no health insurance (OR: 7.2; 95% CI:2.0-25.5) and less likely in those referred for psychological counseling (OR: 0.017; 95% CI:0.05-0.54). Patients had a higher prevalence of mental health conditions than that reported in other studies and often declined diagnostic and therapeutic interventions.

Adult↗
PubMed2006

Prevalence of torture survivors among foreign-born patients presenting to an urban ambulatory care practice.

BACKGROUND: The prevalence of torture among foreign-born patients presenting to urban medical clinics is not well documented. OBJECTIVE: To determine the prevalence of torture among foreign-born patients presenting to an urban primary care practice. DESIGN: A survey of foreign-born patients. PATIENTS: Foreign-born patients, age > or = 18, presenting to the Primary Care Clinic at Boston Medical Center. MEASUREMENTS: Self-reported history of torture as defined by the UN, and history of prior disclosure of torture. RESULTS: Of the 308 eligible patients, 88 (29%) declined participation, and 78 (25%) were not included owing to lack of a translator. Participants had a mean age of 47 years (range 19 to 76), were mostly female (82/142, 58%), had been in the United States for an average of 14 years (range 1 month to 53 years), and came from 35 countries. Fully, 11% (16/142, 95 percent confidence interval 7% to 18%) of participants reported a history of torture that was consistent with the UN definition of torture. Thirty-nine percent (9/23) of patients reported that their health care provider asked them about torture. While most patients (15/23, 67%) reported discussing their experience of torture with someone in the United States, 8 of 23 (33%) reported that this survey was their first disclosure to anyone in the United States. CONCLUSION: Among foreign-born patients presenting to an urban primary care center, approximately 1 in 9 met the definition established by the UN Convention Against Torture. As survivors of torture may have significant psychological and physical sequelae, these data underscore the necessity for primary care physicians to screen for a torture history among foreign-born patients.

Adult↗
PubMed1991

Case vignette: Niki goes to school -- autonomy, control, and psychiatric hospitalization.

The following is a description of a case and a discussion by professionals of the ethical issues raised. Niki turned 18 years old just 3 months ago. She is a freshman student at Central State University, where her father is also a faculty member. Niki has been residing in her parents' home. On Monday afternoon, Niki arrives at the college health service asking for a walk-in appointment. An intake evaluation reveals that she is showing signs of anorexia nervosa and is having suicidal ideation. A decision is made to refer Niki for admission to a local psychiatric facility. She agrees to accept a voluntary admission but advises the staff at both the health center and the hospital that she does not want her parents to know where she is. By Monday evening, Niki's family is very anxious regarding her whereabouts and is telephoning everyone they can think of to try to locate her. Although staff members have been urging Niki to allow them to inform her family of her admission to the hospital, she is still refusing to authorize such disclosure. What should the professionals involved in the case do or say if they are contacted by the parents? What are the parameters of confidentiality in cases of children who are living at home but have attained the age of legal majority?

Adult↗
PubMedDate not supplied

Beyond medical ethics: new directions for philosophy and medicine.

A unique relationship exists between physicians and philosophers -- one that expands on the constructive potential of the liaison between physicians and, for example, theologians, on the one hand, or, social workers on the other. This liaison should focus in the scientific aspects of medicine, not just the ethical aspects. Philosophers can provide physicians with a perspective on both the philosophy and the history of medicine through the ages -- a sense of how medicine has adapted to the social, cultural, and ethical needs of each period. This perspective, while emphasizing medicine as science, should not be limited to matters of methodology, or to criteria for distinguishing science from other intellectual pursuits, but should be concerned also with the history, sociology, and politics of science. Both physicians and philosophers stand to gain from a strengthening of their active liaison now as never before; but most of all, the public will be the beneficiary.

Bioethical Issues↗
PubMedDate not supplied

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Advance Directives↗