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Author Archive: Bernard W Freedman, JD, MPH

About Bernard W Freedman, JD, MPH

Declining Life Expectancy Many nations proudly tout “Life Expectancy” as a reflection of healthcare.  In our country, this statistic has continually edged upward due to expanding technology, doctors/patient education, and vibrant emphasis on healthy lifestyles.  A shift is occurring though as this number is destined to decline with hospital administrators, not physicians, making medical decisions impacting those who are the most vulnerable:  Elder seniors in the ICU. These patients have been targeted by unscrupulous business people converting them to palliative care, with a gateway into hospice.  Why would this be financially beneficial to these administrators? Hospitals are paid a fixed...

The post Declining Life Expectancy – Gene Uzawa Dorio, M.D. – Guest Commentary appeared first on Clinical Bioethics.

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Declining Life Expectancy Many nations proudly tout “Life Expectancy” as a reflection of healthcare.  In our country, this statistic has continually edged upward due to expanding technology, doctors/patient education, and vibrant emphasis on healthy lifestyles.  A shift is occurring though as this number is destined to decline with hospital administrators, not physicians, making medical decisions impacting those who are the most vulnerable:  Elder seniors in the ICU. These patients have been targeted by unscrupulous business people converting them to palliative care, with a gateway into hospice.  Why would this be financially beneficial to these administrators? Hospitals are paid a fixed...

The post Declining Life Expectancy – Gene Uzawa Dorio, M.D. – Guest Commentary appeared first on Clinical Bioethics Blog.

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In a major medical center in California a 74-year-old patient who suffered a stroke had been in a coma and on a ventilator for one month. There were a variety of complications and comorbidities. According to his physicians the patient was not in a persistent vegetative state, but in a coma. The physicians recommended that the son and surrogate decision maker, consent to withdrawing the vent and allowing his father to die peacefully. His son was also admonished that if he did not consent he would then have 10 days to get his father out of the hospital or his...

The post Death Panels are Alive appeared first on Clinical Bioethics Blog.

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In a major medical center in California a 74-year-old patient who suffered a stroke had been in a coma and on a ventilator for one month. There were a variety of complications and comorbidities. According to his physicians the patient was not in a persistent vegetative state, but in a coma. The physicians recommended that the son and surrogate decision maker, consent to withdrawing the vent and allowing his father to die peacefully. His son was also admonished that if he did not consent he would then have 10 days to get his father out of the hospital or his...

The post Death Panels are Alive appeared first on Clinical Bioethics.

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  With the onslaught of media coverage of the Jahi McMath case it is time for a public debate on whether or not the loss of upper and lower brain function should determine death.  Brain death is the cessation of any brain activity in the uppe...

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With the onslaught of media coverage of the Jahi McMath case it is time for a public debate on whether or not the loss of upper and lower brain function should determine death.  Brain death is the cessation of any brain activity in the upper brain as well as the lower brain or brain stem. The McMath case should be distinguished from the Terri Schiavo case where only upper brain function was in question. Ms. Schiavo was not determined to be brain dead, but rather a living person in a persistent vegetative state. Brain death is established by numerous objective...

The post Exploiting despair – the death of Jahi McMath appeared first on Clinical Bioethics Blog.

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12/30/2013 Making Choices
  New Year resolutions are sometimes easy to make but hard to keep. Resolutions are choices, choices to live on and to better ourselves. For patients who are critically ill, resolve is often in short supply.  So, to physicians reading this I ...

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12/30/2013 Making Choices

New Year resolutions are sometimes easy to make but hard to keep. Resolutions are choices, choices to live on and to better ourselves. For patients who are critically ill, resolve is often in short supply.  So, to physicians reading this I ask that one of your resolutions this coming year is to speak with patients about their end of life choices and help other physicians do the same. Many physicians are either reluctant to broach the subject, or not very good at discussing these issues, or both. Many feel that they will “cross that bridge when they get to it,”...

The post Making Choices appeared first on Clinical Bioethics Blog.

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  The Problem with POLST Over the years, informed consent has been given short shrift. There is, however, a growing understanding of the importance of obtaining an actual and legitimate consent before  having a patient accept or reject m...

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The Problem with POLST Over the years, informed consent has been given short shrift. There is, however, a growing understanding of the importance of obtaining an actual and legitimate consent before  having a patient accept or reject medical treatment. Autonomy, transparency, respect, dignity, and other similarly recognized human rights are increasingly recognized as legal and ethical requirements. “POLST” (Physician Orders for Life-Sustaining Treatment) however, makes it easy and even inviting to avoid these requirements with the stroke of a pen on a conclusionary form. POLST only makes sense in cases of patients with terminal illnesses, in end stage disease with no...

The post The Problem with POLST – Physician Orders for Life-Sustaining Treatment appeared first on Clinical Bioethics Blog.

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