A Neurologist, Partner with Global Neurology Consultants, and Founding Director of the nonprofit organization Global NeuroCare, Dr. James C. Johnston is a Diplomate of the American Board of Psychiatry and Neurology, and a Fellow of both the American College of Legal Medicine and the Australasian College of Legal Medicine. Dr. James C. Johnston is a widely published author with recent articles appearing in the Neurologic Clinics; Medical Law International; Neurology; Surgery Journal; and several other peer-reviewed medical journals.
The Surgery Journal published two articles from Dr. Johnston and his colleagues, the most recent entitled “The Ethics of Teaching Physicians Electronic Fetal Monitoring – And Now for the Rest of the Story.” Dr. Johnston and his colleagues Professor Berna Arda and Thomas P. Sartwelle, composed an articulate critique of electronic fetal monitoring (EFM) as a method of predicting and preventing cerebral palsy (CP). The article draws upon Mr. Sartwelle’s decades of experience as a top medical malpractice defense attorney, Dr. Johnston’s considerable medical and legal expertise, and Professor Arda’s unique views of medical ethics gained by her years of teaching at Ankara University where she holds the Chair of Medical Ethics.
“The Ethics of Teaching Physicians Electronic Fetal Monitoring” reviews the history of EFM with a specific focus on CP. Citing the available literature, the article concluded that, not only has EFM proven ineffectual in the diagnosis and prevention of CP, it increases the rate of cesarean sections with concomitant harms to mothers and babies alike. Further, Dr. Johnston and his colleagues stated that EFM, as it is used in defensive medical practice, is a violation of patient autonomy and raises serious ethical concerns. The article may be accessed through the link below:
A neurologist in private practice, Dr. James C. Johnston is also a partner with Global Neurology Consultants. In addition, Dr. James C. Johnston is the founder and director of Global NeuroCare, an international nonprofit organization dedicated to improving neurological services worldwide. Global NeuroCare focuses on sub-Saharan Africa.
As a region, sub-Saharan Africa faces a number of obstacles preventing treatment of neurological disorders such as epilepsy. Cultural beliefs play a major role in epilepsy treatment, with family members often hiding the condition, believing that seizures are caused by supernatural forces. People with epilepsy are generally shunned by society, and children may be prohibited from attending school. This phenomenon is not unique to the developing world, as people with epilepsy in developed nations may face various forms of discrimination.
Access to specialist neurology care also presents a major challenge in sub-Saharan Africa. According to a 2009 study published in the journal Seizure, the average round-trip transit time to rural epilepsy clinics in Ethiopia was more than 10 hours, and these are clinics without neurologists, imaging facilities or EEG equipment.
Because most antiepileptic medications are prohibitively expensive or simply unavailable, physicians typically only have access to the anti-epileptic drug phenobarbital. Not only does phenobarbital have numerous adverse side effects, it also limits neurologists in terms of treatment options. As such, it is not surprising that the International League Against Epilepsy cited consistent access to medication as the most important obstacle to bridging the treatment gap in sub-Saharan Africa.
Under the direction of Dr. James C. Johnston, Global NeuroCare works closely with the Addis Ababa University Department of Neurology in an effort to increase the number of locally trained neurologists, advance patient care and overcome some of the obstacles impeding neurological services.
The United Nations ECOSOC accepted a statement by Dr. James C. Johnston on behalf of Global NeuroCare for presentation at the 55th Session of the Commission for Social Development 2017. In that statement, Dr. Johnston highlights specific recommendations for developing and improving health care services in resource limited areas. He also suggested appointment of a Special Rapporteur or Independent Expert with a thematic mandate of Global Health to examine, advise and publish relevant guidelines for the ethical promotion of North-South collaborative partnerships, especially in Africa.
This represents an extension of the recommendations Dr. James C. Johnston submitted for the UN ECOSOC High Level Political Forum on 27 July 2016.
American Academy of Neurology
Having received his medical degree from the University of Texas Health Science Center in San Antonio, TX, Dr. James C. Johnston is board-certified by the American Board of Psychiatry and Neurology. He holds additional certification in rehabilitation medicine. Practicing medicine for over 25 years, Dr. James C. Johnston specializes in neurology and is a member of the American Academy of Neurology (AAN), World Association for Medical Law (WAML), and Fellow of both the American and Australasian Colleges of Legal Medicine.
Dr. James C. Johnston attended the AAN Annual Meeting in Vancouver, British Columbia in April of this year. The World Association for Medical Law recently held the annual Congress of Medical Law in Los Angeles during August 7-11 where Dr. James C. Johnston presented a lecture on The Ethical and Legal Challenges of Global Health Development. Dr. Johnston based this presentation on his work through Global NeuroCare, a 501(c)(3) nonprofit organization that is in Special Consultative Status with the United Nations.
Shortly before the WAML meeting Dr. James C. Johnston presented a written statement to the United Nations ECOSOC High Level Political Forum providing recommendations to improve global health partnerships.
Along with co-authors Thomas Sartwelle and Professor Berna Arda, Dr. Johnston also presented on Electronic Fetal Monitoring and Cerebral Palsy at the WAML meeting, following several recent publications on this topic with the same co-authors.
James C. Johnston, MD, JD recently published a written statement for the High Level Political Forum of the 2016 United Nations ECOSOC meeting. This statement raised concerns that many of the global health programs at United States academic medical centers have focused on brief, self-centered medical missions to resource limited areas, which may cause significant harm to host nations. Recommendations for improvement were provided. A summary of this statement is available at the UN Documents Center online, and at Researchgate.
The Addis Ababa University Department of Neurology in Ethiopia recently celebrated the 10 year anniversary since inception of the neurology residency training program. To date, 28 physicians have graduated and passed their board examinations to qualify as specialists in neurology. Dr. James C. Johnston, serving as an honorary Professor of Neurology and External Examiner for the examinations recently commented: “These dedicated physicians are excellent clinicians providing outstanding neurological care despite severe resource limitations.”
James C. Johnston, MD, JD is also founder of the non-profit organization GlobalNeuroCare.org which focuses on improving neurological care in developing nations. GlobalNeuroCare has maintained Special Consultative Status with the United Nations ECOSOC since 2013.
Neurologist and attorney Dr. James C. Johnston has published several articles in peer-reviewed journals discussing electronic fetal monitoring (EFM) and cerebral palsy. In the 4 April 2016 Journal of Childhood and Developmental Disorders, Dr. James C. Johnston and Thomas P. Sartwelle discuss the myths behind EFM, outline the ethical dichotomy created by this scientifically flawed procedure, and propose a solution to change the clinical standard of care by linking EFM to the Daubert exclusionary evidence doctrine, thereby ending cerebral palsy-EFM litigation. (See: Thomas P. Sartwelle, BBA, LLB and James C. Johnston, MD, JD. Cerebral Palsy and Electronic Fetal Monitoring: Rearranging the Titanic’s Deck Chairs. J Child and Dev Disord 2016; 2(2:5):1-10).