Ep. 151 Brain Death: Challenges and Responses
Does it matter if we call irreversibly comatose patients “dead?” Our guest is Doyen Nguyen, OP, MD, STD. Dr. Nguyen was previously an academic hemato-pathologist and is currently a Catholic moralhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC5749302/ theologian and bioethicist. She has authored books and articles both in medicine and in moral theology/bioethics and authored a 600-page monograph that takes a critical look at brain death from a variety of perspectives.
LINKS:
- Nguyen D. The New Definition of Death for Organ Donation: A Multidisciplinary Analysis from the Perspective of Christian Ethics. (2018, Amazon link)
- Nair-Collins, M and Miller, FG. “Do the ‘Brain Dead’ merely appear to be alive? (in J of Med Ethics, open access)
RELATED EPISODES:
Ep. 35 Why Brain Death Isn’t Death: An Introduction to “Shewmon’s Challenge” (with guest Alan Shewmon, MD)
Ep. 45 Brain Death at the Bedside (with guest Fred Rincon, MD)
Ep. 146 Diagnosing Brain Death: Clinical and Legal Quagmire (with guests Alan Shewmon and Doyen Nguyen)
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Ep. 150 David Cayley on Ivan Illich
Our guest is David Cayley, author and broadcaster based in Toronto, Canada, whose career focused on the philosophies of major contemporary thinkers and on the history of intellectual thought. For 30 years, he made radio commentaries for the acclaimed Ideas radio series produced by the CBC. He is well known for his close collaboration and friendship with the philosopher and social critic Ivan Illich who is the subject of this episode.
GUEST:
David Cayley: Website
LINKS:
Note: The Accad and Koka Report participates in the Amazon Affiliate program and may earn a small commission from purchases completed from links on the website.
- “David Cayley. “Questions about the current pandemic from the viewpoint of Ivan Illich.” (blog post, April 8, 2020)
- Ivan Illich. Limits to Medicine: Medical Nemesis; The Expropriation of Health (Amazon link)
- David Cayley and Ivan Illich. Rivers North of the Future: The Testament of Ivan Illich (Amazon link)
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Ep. 149 James Lindsay: Critical Race Theory, Post-Modernism, and Medicine
An American-born author, mathematician, and political commentator, Dr. James Lindsay has written books spanning a range of subjects including religion, the philosophy of science and postmodern theory. He is the co-founder of the website New Discourses and is currently promoting his new book “Cynical Theories”. Enjoy a wide ranging discussion on the Post-Modern movement and how it impacts Medicine
GUEST:
James Lindsay: Twitter and New Discourses Web page
SHOW NOTES:
Amazon book link: Cynical Theories
John Stuart Mill Essay: On Liberty
Anish’s article in Quilette on the Real Gender gap in Cardiology: https://quillette.com/2019/06/12/the-real-gender-gap-in-heart-disease/
New Discourses website: https://newdiscourses.com/
Podcast on race and estimated GFR: https://podcasts.apple.com/us/podcast/race-and-estimated-gfr/id1461664501?i=1000488650915
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Ep. 148 David Heymann and Paul Fine: Herd Immunity Models and Realities
Our guests are Professors David L. Heymann and Paul Fine from the London School of Hygiene and Tropical Medicine. Professor Heymann is a physician who held leading positions at the WHO for more than 20 years, coordinating global responses to epidemics such as Ebola, AIDS, polio, and SARS. He also served as Chairman of Public Health England from 2009 until 2017. Professor Fine is also a leading academic figure in epidemiology and public health with broad interests in infectious diseases. Professor Heymann and Professor Fine, along with colleague Ken Eames, have co-authored an landmark review paper on the concept of herd immunity.
GUESTS:
David Heymann: Professional page and Wikipedia page
Paul Fine: Professional page
LINKS:
- Paul Fine, Ken Eames, and David Heymann: “Herd Immunity”: A “Rough Guide (Open Access in Clinical Infectious Diseases)
- David Heymann: How SARS Was Contained (Opinion in New York Times)
RELATED EPISODES:
Ep. 140. Gabriela Gomes: Why Herd Immunity May Be At Hand
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Ep. 147 Sally Satel: Should Med Schools Teach Antiracism?
Our guest is physician and author Sally Satel, MD. Dr. Satel is a resident scholar at the American Enterprise Institute and staff psychiatrist at a local methadone clinic in the Washington DC area. She earned a bachelor’s degree from Cornell University, a master’s degree from the University of Chicago, and an MD degree from Brown University.
She has written widely in academic journals on topics in psychiatry and medicine, and has published articles on cultural aspects of medicine and science in numerous magazines and journals. She has testified before Congress on veterans’ issues, mental health policy, drug courts, and health disparities. She is the author of numerous books including The Health Disparities Myth:Diagnosing the Treatment Gap with co-author Jonathan Klick and, most recently, Brainwashed: The Seductive Appeal of Mindless Neuroscience co-authored with Scott Lilienfeld.
GUEST:
Sally Satel, MD: Twitter and Website
LINKS:
- “The Hypocritical Oath” (in Persuasion online community)
- The Health Disparities Myth: Diagnosing the Treatment Gap (with co-author Jonathan Klick)
RELATED EPISODES:
Ep. 144 John Mandrola: Why Doctoring and Politics Shouldn’t Mix
WATCH ON YOUTUBE:
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SUPPORT THE SHOW:
Make a small donation on our Patreon page on and join our discussion group or receive a free book.
Ep. 146 Diagnosing Brain Death: Clinical and Legal Quagmire
Our guests are Doyen Nguyen, OP, MD, STD and D. Alan Shewmon, MD. They join us to discuss troubling development on the legal treatment of brain death.
Dr. Nguyen was previously an academic hematopathologist and is currently a Catholic moral theologian and bioethicist. She has authored books and articles both in medicine and in moral theology/bioethics and authored a 600-page monograph that takes a critical look at brain death from a variety of perspectives.
Dr. Shewmon is Professor Emeritus of Pediatric Neurology at UCLA. His work, comprising decades of well-documented clinical observations and reflections, is now known as “Shewmon’s challenge,” a compelling rebuke to the principal arguments put forth to defend the concept of brain death.
LINKS:
- Shewmon DA. “Chronic “brain death”: Meta-analysis and conceptual consequences.” (in Neurology, 1998)
- Lewis A, et al. “Determination of Death by Neurologic Criteria in the United States: The Case for Revising the Uniform Determination of Death Act” (in J. of Law, Medicine, and Ethics, 2019)
- President’s Commission for the Study of Ethical Problems in Medicine, Biomedical and Behaviora Research. “Defining Death” (1981)
- Nguyen D. The New Definition of Death for Organ Donation: A Multidisciplinary Analysis from the Perspective of Christian Ethics. (2018, Amazon link)
- Nguyen, D. “Does the Uniform Determination of Death Act Need to Be Revised?” (2020, Linacre)
RELATED EPISODES:
Ep. 35 Why Brain Death Isn’t Death: An Introduction to “Shewmon’s Challenge” (with guest Alan Shewmon, MD)
Ep. 45 Brain Death at the Bedside (with guest Fred Rincon, MD)
WATCH ON YOUTUBE:
Watch the episode on our YouTube channel
SUPPORT THE SHOW:
Make a small donation on our Patreon page on and join our discussion group or receive a free book.
Ep. 145 Damian Carabello on Surprise Billing: Through the Looking Glass
Dr. Damian Carabello discusses the depths insurance companies go to make sure they end up on top.
GUEST:
Damian Carabello, MD: Twitter
LINKS:
- Anish Koka long read on surprise billing
- Damian Carabello “Let’s end surprise billing without a Trojan horse” blog on KevinMD about the problems with benchmarking.
- Twitter thread on the history of Ingenix
- Andy Slavitt’s involvement with health insurance fraud case
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Make a small donation on our Patreon page on and join our discussion group or receive a free book.
Ep. 144 John Mandrola: Why Doctoring and Politics Shouldn’t Mix
Dr. John Mandrola returns to the show to discuss why doctoring and politics shouldn’t mix and how he got into hot water on Twitter for holding that unacceptable view.
Dr. Mandrola is an electrophysiologist in Louisville, Kentucky. He is is cardiology editor on Medscape where he writes a regular column and produces a weekly podcast.
GUEST:
John Mandrola, MD: Twitter and Website
LINKS:
- John Mandrola: “Doctoring and Activism“
- Sally Satel: “The Hypocritical Oath“
- Mandrola et al: The Case for Being a Medical Conservative (in the American Journal of Medicine)
PREVIOUS GUEST APPEARANCES:
Ep. 12 John Mandrola: The Case for “Less-Is-More”
Ep. 107 Independent Nurse Practitioners: Public Health Threat or Libertarian Step Forward?
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Ep. 143 Adam Mortara on Litigating Affirmative Action
Our guest is Adam Mortara, lead trial counsel in the case of Students for Fair Admissions v. Harvard University. We discuss the legal aspects of affirmative action in light of the paper by Dr. Norman Wang which set off a storm of controversy in academic medicine.
GUEST:
Adam Mortara, JD: Professional page
LINK:
Norman Wang’s paper: Diversity, Inclusion, and Equity: Evolution of Race and Ethnicity Considerations for the Cardiology Workforce in the United States of America from 1969 to 2019.
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Ep. 142 Robert Yeh on Harnessing Real World Evidence
Our guest is Robert Yeh, Associate Professor of Medicine at Harvard Medical School and Director of the Smith Center for Outcomes Research in Cardiology at the Beth Israel Deaconess Medical Center in Boston. We discuss the challenges of outcomes research and his excellent work to improve the reliability of observational studies
GUEST:
Robert W. Yeh, MD: Twitter and professional web page
LINKS:
- Strom JB, et al. Use of Administrative Claims Data to Assess Outcomes and Treatment Effects in Randomized Trials of Transcatheter Aortic Valve Replacement (in Circulation)
- Faridi KM, et al. Use of Administrative Claims Data to Estimate Treatment Effects for 30 days versus 12 months of Dual Antiplatelet Therapy After Percutaneous Coronary Intervention (in Circulation)
- Konstam M. Real World Data as trial End Points: Off and Running with a Long Way to Go (editorial in Circulation)
PREVIOUS GUEST APPEARANCE:
Ep. 19 Public Reporting: Necessary Evil or Harmful Fake News?
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