tv Full Measure With Sharyl Attkisson ABC June 5, 2016 10:00am-10:30am EDT
[captioning performed by the national captioning institute, which is responsible for its caption content and accuracy. visit ncicap.org] ♪ sharyl: welcome to "full measure." i'm sharyl attkisson. hospitals can be dangerous places. it's estimated up to 440,000 americans a year die from preventable hospital errors, the third leading cause of death in the u.s. that risk can be exacerbated by doctors who are tired and more prone to mistakes. so why are some in the medical community pushing hard to work doctors on longer, more brutal shifts? we begin today with a controversial study going on
right now at 63 hospitals, including the university of pennsylvania, johns hopkins, and yale university. the test subjects are hundreds of thousands of patients who have no idea they're in a study, and thousands of doctors who have little choice but to take part. dr. michael carome: it's clearly unethical research. it's among the most unethical research i've ever seen, in fact. sharyl: dr. michael carome is a medical ethicist with the watchdog group public citizen. he's talking about the controversial study icompare. funded with millions of your tax dollars, it's testing the endurance of young physicians to see, quite literally, do more patients die when their doctors work longer shifts? dr. carome: there is substantial evidence that residents who are sleep deprived, particularly first-year residents, make more medical errors. and those medical errors can lead to harms and even deaths to patients. sharyl: if it seems like a no-brainer, carome says it is. he should know -- he himself attended medical school and completed a residency.
so, right now, there is a limit? dr. carome: there is a limit, and for the most stringent limit is for first-year residents, fresh out of medical school. and for those residents, there is a maximum of 16 consecutive hours that they're allowed to work, and that limit was imposed by the accreditation body in 2011. sharyl: yet in icompare, residents can be assigned to shifts that break the normal rules and far exceed the 16-hour limit. they may work up to 28 hours straight. so, are the patients of the sleep-deprived residents being told, "you're being cared for by somebody who isn't following the normal protocol"? dr. carome: no, they are not. sharyl: that's the most egregious problem, carome says, that icompare violates basic tenets of human research -- informed consent rules requiring that test subjects be told about -- and choose whether to take part in -- any research.
dr. carome: there are actually two groups of subjects in this study, there's the patients of the residents, and there's the residents themselves. and informed consent, which is again is a fundamental ethical requirement for research like this, isn't being obtained for either of those groups. now the residents, they know they're in the research because they're being told, but they don't have a choice. they're told, but it's not consent. they're forced to participate in the research. if they don't like being in the research, they can quit the training program and that could be very damaging to their career, so it's very coercive to them. sharyl: dr. robert klitzman is on the other side of this debate. he's a bioethicist at columbia university mailman school of public health. dr. robert klitzman: there's a tension. on the one hand, we wanna have doctors who are awake, but we don't wanna have so many doctors coming and going and coming and going, that there's gonna be a breakdown in care. sharyl: according to klitzman, patients benefit from doctors
working longer shifts -- fewer handoffs mean continuity in care. he says it's not necessary to tell patients they're in the study and being seen by doctors working outside the normal rules because there's little risk. dr. klitzman: we want science to go forward that can help people and help their lives. but if, sometimes, to do that science, if you had to get informed consent from every single person -- and the study is minimal risk, that there's no more risk than there would be if you weren't in the study, basically -- that we say, "you know what? in these cases, if we asked for informed consent, we're not gonna be able to do the study." sharyl: in other words, icompare researchers assume sleepy doctors aren't more dangerous, so there's no reason to tell patients they're in a study to see if that's true. carome says that's faulty circular reasoning and that unsuspecting patients at 63 hospitals are being put at "increased risks of medical errors and death." the issue of sleepy doctors has long b
current work hour limits were prompted by the case of teenager libby zion. she died at a new york hospital in 1984 under the questionable care of exhausted residents, who routinely worked 36-hour shifts. and then there's the case of 15-year-old lewis blackman who had minimally invasive surgery at a south carolina hospital. in this web video, his mother says numerous overtired residents and interns missed signs that medicine was eating a hole in her son's intestines after surgery. lewis bled to death in the hospital. helen haskell: and he said, "we lost him." that made no sense to me. it didn't fit into anything, anything that we had understood. five minutes before this happened, they were still telling us he was fine.
limits on their hours -- 80 hours a week and 16 hours straight -- young doctors push the bounds of endurance. after a resident in mexico was criticized for getting caught on camera napping at a hospital desk last year, others rushed to her defense. they posted images of themselves sleeping on the job during punishing shifts -- pictures like this one of caro leyva santoya, who's training in mexico and spoke with us via skype. caro leyva santoya: so, it's pretty bad if you haven't sleep, you haven't eat,ou haven't rest, how did you imagine my brain is going to work treating a patient like in the emergency room? dr. carome: there is substantial evidence in literature that tired residents are more likely to have motor vehicle accidents, are more likely to injure themselves while caring for patients -- poking themselves with a needle, maybe, that was used to draw blood, and that can lead to blood-born infections like hiv, hepatitis being transmitted from a patient to the resident. sharyl: psychiatry resident
david harari and a colleague at the university of washington, one site where icompare is underway, wrote this editorial in december. "conducting this research without the informed consent of residents and patients violates the basic ethical principle of respect for persons. adequate sleep is a fundamental physiological need. no amount of caffeine, prescription stimulants, or 'alertness management strategies' can adequately compensate for acute and chronic sleep deprivation." do hospitals save money if they keep doctors on these longer schedules -- what's their motivation? dr. carome: residents are the cheapest labor for these hospitals, and if you cut back on their hours, then you have to make that up somewhere to still deliver the same medical care. and that obviously would be more expensive, so i think, unfortunately, financial cost and greed are one of the motivators here. sharyl: icompare's lead researcher, david asch of the university of pennsylvania, declined our interview requests. the
past that "patient safety is always our top priority" and , "the study was designed and vetted by regulatory bodies, research review boards, and established ethics panels." even without knowing how this study will turn out, klitzman thinks there's already enough evidence to favor longer shifts for doctors with fewer handoffs. dr. klitzman: if you were to ask people in a surgery, "do you wanna have one doctor be the one who sees you from beginning or end, or doctors coming and going, each turning over the knife to the next one?" i think most patients would say they prefer to have one doctor. sharyl: not if he's on hour 28, says carome. some doctors, don't they wear those hours as a badge of honor, sort of like "i did that when i was a resident, what's the big deal, i was fine"? dr. carome: we used to have pilots fly airplanes without sleep restrictions, and that was deemed to be unacceptable because we know that tired
pilots are more likely to have to make mistakes that could lead to catastrophic crashes. the fact that medicine, for years, maybe 100 or more years, has allowed doctors, who are particularly trained to work almost unlimited hours, that doesn't mean that it's acceptable. doctors are not physiologically different than other human beings, they're just like pilots, they're just like truck drivers, and, for some reason, you know, senior doctors think they're impervious to the effects of sleep deprivation, and that's simply not true. sharyl: months ago, public citizen called for the study to be suspended immediately and asked for an investigation by the federal ethics body that oversees such matters, the office for human research protections, but it's taken no action. the study ends next month. ahead on "full measure" -- the state of the grand old party. we'll talk with veteran republican rebel newt gingrich about whether donald trump is good for the gop.
rankles some party insiders. in another time, newt gingrich was the republican rebel. we sat with the former speaker of the house and asked if there was a crisis in the party. newt gingrich: well, i think there's a really big, deep argument about the future of the party, but it's not much of a crisis, it's 80% or 90% of the party nationally versus 5% or 10% of the party in washington. so in the end, washington will lose and the country will win. sharyl: is trump, do you see, as part of the solution or part of the problem? newt: i don't know yet if he's a solution because we don't know how he's going to work out, but he certainly is a sign that the unhappiness in the country is so deep that trump made more sense than 16 other choices. there were a lot of really smart, competent people running for president. he beat all of them. something is happening out there and he resonates with something in the american people. the country wants somebody who's going to kick over the table. sharyl: do you agree that that's what they should get? newt: absolutely. i think the system is sick and i
sharyl: in 1995, "time" named you man of the year for your role in ending the four-decades-long democratic majority of the house. quite a feat. newt: it was wild. i mean, you had democrats who literally had served forty years without ever having a republican take control of the house. the only republican in congress who had been a republican majority who was bill henderson of missouri, who had been a page the last time they were in charge. the first couple days after we took over, the democratic chairman would come in and automatically sit in the chairman seat and a staffer would say, you are now in the ranking member costs seat. seat.king member's we passed welfare reform, which is the most successful conservative reform in modern times, we balanced the budget
your lifetime you've had four consecutive federal balanced budgets, we did it. so we were very, very aggressive, and that reform energy lasted about three and a half years. sharyl: you said it lasted about three and a half years, this revolution -- what happened? newt: it got worn out. we were a populist insurgency against the establishment. and establishments, as trump will discover, establishments have enormous staying power. they've built in laws and regulations and bureaucracies and lobbyists, friends in the news media, the bias against dramatic change is very deep. sharyl: do you see any parallels between your popularity in 1994 and the fall after three years and what you foresee for donald trump? newt: sure. i think what trump has to understand is if he does win, and if he is serious about reform, that washington will resemble madison, wisconsin times ten. so, whatever the size of the huge demonstrations at the unions that the liberals put on against scott walker's reforms, you have to expect them to be much bigger, much more bitter, much more hostile here.
sharyl: what's the biggest threat to trump's supposed success or what he may have as success? newt: well, right now the biggest threat to trump is trump. trump has the biggest upside and the biggest downside of any candidate i've ever seen. sharyl: do you think he wins, or does hillary win, or does bernie sanders? newt: i think trump probably wins. sharyl: have any of your interests had any conversations with any of trump's interests about a possible place in the administration in a trump administration? newt: i don't have interests, so i don't know. [laughter] sharyl: well, have you? and i'm trying to cover all the people around you. newt: no, we haven't talked about it at all. sharyl: would you welcome such a conversation? newt: it's up to donald. sharyl: on an upcoming full measure, we will talk to him about early america and what most americans don't know about george washington. ahead on "full measure" -- when the u.s. inked the deal with iran, four americans accused as spies were released. but what happened to the longest held american captive in history? we will talk with an author about the mystery of bob levinson when we return.
sharyl: bob levinson. a father of seven. a former fbi agent of 23 years turned private investigator. and now, the longest-held american captive in history. how that came to be is the cloak and dagger story pieced together by journalist barry meier, author of the just published "missing man: the american spy who vanished." scott thuman sat down with the author to learn what he has found after investigating this cold case that has haunted the levinson family for the last nine years. pres. obama: several americans unjustly detained by iran are coming home. scott: that announcement was made in january, several months after the u.s. sealed a deal to reduce economic sanctions against iran, if it agreed not to pursue nuclear weapons. since iran is the last known place that bob levinson was seen, his family, says author barry meier, thought he would be among those freed.
>> they were stunned when it was announced these other prisoners were coming home and the administration didn't have courtesy to notify them. they learned about it from watching the news like every other american. scott: though levinson is not like every other american. to this day, the iranians have never acknowledged holding him captive. the mystery begins in 2007 when levinson, supposedly as a private investigator, went to kish, an iranian free trade zone in the persian gulf where americans do not need a visa. then he vanished. meier began his own investigation into what happened to levinson. first, he gained the levinson family's trust and then troves of bob's personal work files. barry: and there inside a conference room was ten large bankers boxes full of files. it was entry int
world that bob lived in. scott: a secret world, meier says, of gathering information on iran as a contractor for the cia. meier says the family had bob's computer hacked after he disappeared that led a paper trail to the cia. barry: i had hundreds of reports that he had sent back and forth between him and his cia handler, so it was undisputable. scott: so if levinson was working for the cia, why would the agency deny it? the cia declined to comment to "full measure," but meier has his own idea. barry: they will not say bob levinson was a cia consultant, that he went to iran to gather information for the cia. they are refusing to do that because they don't want to admit that we are in the business of collecting intelligence about our friends or enemies. scott: it would be an admission that could endanger other americans overseas, who would be treate
hostile nations. the first hint about levinson's disappearance, meier says, came in 2007 in an email apparently from bob and sent to his family and the fbi. barry: it was one of the most tantalizing clues. this email appeared to be written by levinson pleading for help. they never followed up, never. with any of these individuals. scott: the fbi wouldn't comment, but issued a statement on the ninth anniversary of levinson's disappearance saying it continues to work closely with our intelligence community and international partners to locate bob and bring him home safely. >> i've been held here for three and a half years. i'm not in very good health. scott: in 2010, this video of bob levinson emerged. the first and last sign that he was still alive. for years, the government, the levinson family, and even the press kept to what meier
he had traveled to iran to investigate cigarette smuggling. barry: very early on we were facing a choice. we knew bob was a consultant to the cia. we didn't know whether he was dead or alive. the story that we had was not worth gambling someone's life over. scott: that changed in 2013. the associated press and "washington post" decided to break the story that levinson was collecting information for the cia and that it sparked a scandal inside the cia. barry: at some point, heads rolled. the explanation was that they had run rogue operation and violated the cia traditions. what has never been acknowledged is that bob was collecting intelligence about iran. jay carney: bob levinson was never an employee of the united states government. scott: bob's family h
him back. they have gone to congress. >> my family will never rest until my father is back home with us. scott: and levinson's son dan even traveled to iran to try to find him. still, nothing. they have no answers, just questions. barry: they are a family who has no closure. they wake up every morning wondering whether something will happen to resolve this case. and that has been happening day after day after day. and they deserve much better. cheryl: fbi director james comey stated that they are doing everything within their power to investigate all leads. still to come, food stamps are supposed to help people, but some people are helping themselves to what may be black-market profits.
sharyl: in "follow the money," the number of americans getting food stamps, that's an allowance of tax dollars to buy food, has risen sharply. and that's heightened concerns about food stamp fraud. in 2000, 17.2 million people received food stamps. the current number is about 44 million. exactly how much of that is fraud, or criminals selling food stamps on the black market, is impossible to know. but republican mark meadows of the house oversight committee says it could be significant.
rep. meadows: one of the prime examples that was shocking to me, sharyl, was we had maine looking at the five cities that had the most food stamp usage in maine. well, none of those five cities are in maine. sharyl: so where were most of the food stamps handed out to maine residents actually used to buy food? amazingly, meadows says it was the bronx, brooklyn, philadelphia, las vegas, and kissimmee, florida. rep. meadows: now, this is maine and yet those are the five cities that have the most use of food stamps and, what, americans are very compassionate, they want there to be a safety net there, but they don't want to be taken advantage of either. sharyl: meadows plans to dig into the maine food stamp example at an upcoming congressional hearing. nationally, since 2000, food stamp costs to taxpayers have more than tripled from around $21 billion to more than $75 billion this year.
on the next "full measure," donald trump is heading to cleveland as the presumptive republican nominee. protests are expected to follow. is cleveland ready for the clash? some don't think so. >> are you afraid your guys are going to get hurt? >> yeah, there's definitely going to be guys that are going to get hurt. i would love to be able to tell you guys that we're in a good place right now, and that we're ready for this. and i can't. i can't. sharyl: that's next week on "full measure." that's all for this week. thank you for watching. i'm sharyl attkisson. until next time, we'll be searching for more stories that hold powers accountable. ♪
this week on "government matters" -- >> it is part of the answer. >> the federal push to buy smarter and more like a single enterprise. we talked about the future of category management. >> they can hack anyone anywhere by asking any federal magistrate or judge where the crime is suspected to have happened. >> the latest in the tug-of-war goes by rule 41. we talked cyber legislation. >> one of the challenges with energy efficiency is so many opportunities in different parts of our economy. >> do you have the energy star label on a home appliance? she created it? "government matters" starts right now. >> from abc 7 and news channel