Does anyone know where  medicare and BUMMERCARE  STAND ON THESE ISSUES IF
TAX DOLLARS ARE GOING INTO  R&D OR SUPPLY TO END USERS(PATIENTS).CL
On Tuesday, August 16, 2016, Mary-Anne Wolf <[email protected]> wrote:

> Here
> http://file.scirp.org/pdf/OJOG_2015012313592885.pdf
> is an example of doctors reporting how they needed to make adjustments to
> a pacemaker when the patient was pregnant.
> I remember hearing a talk by someone who had a pacemaker, got pregnant,
> and could not have the settings changed. She said, at the time the overlap
> of people with pacemakers and those who got pregnant was too small for the
> vendor to have included that ability.
>
> While I can understand why it would be possible to do harm by adjusting
> the settings in the wrong way, we have an example here of a medical device
> where a level of openness was essential to the well being of the patient,
> so clearly that even the doctors knew.
>
> A difficulty of restricting the ability to change settings to officially
> trained staff, as was done here, is that the priorities and perspective of
> the patient may not match the priorities and domain expertise of those who
> treat them.
>
> Here is an example of a doctor discussing that difference.
> http://starlafitchmd.com/can-being-a-patient-make-us-better-doctors/
> "allow me to apologize to my patients. I had no idea. None."
>
> With wheelchairs, is it more important to adjust the center of gravity in
> a manual chair so as to make it
> less likely that the chair falls over backwards when climbing a steep
> ramp?  Or is it more important to adjust so as to minimize the patient's
> fatigue in getting the chair to move?  Patients may differ in what they
> prefer, or the same person may change their mind over time.
>
> Is it more important to introduce a delay in response to the joy stick
> controlling a power wheelchair, so that a 98 year old nearly blind person
> with shaking hands will not move the chair by mistake?  Or is it more
> important that a healthier 54 year old person can avoid running over the
> small child who is moving unpredictably in a supermarket?  The pacemaker
> vendors are ahead of wheelchair vendors in understanding the need to adjust
> and customize.
>
> Mary-Anne
>
>

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