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Author Archive: Thaddeus Mason Pope

About Thaddeus Mason Pope

08/30/2015

Kevorkian "Coma" [EOL in Art 111]

In "Coma" Jack Kevorkian depicts an unconscious patient being slowly pulled into the mouth of a macabre death mask. Helpless. The death's head resembles the opening of a CAT scan machine, a symbol of modern medical technology.

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08/30/2015

New Futility Case: Siner v. Kindred Hospital Indianapolis

The Court of Appeals of Indiana issued a decision that allows a family to proceed with its medical malpractice action alleging that a hospital's unilateral DNR order caused the patient's death. 

Facts
"October 26, 2007, eighty-six-year old Geraldine Siner became a patient at Kindred Hospital. Geraldine suffered from advanced dementia caused by Alzheimer’s disease and as a result could no longer care for herself. Geraldine’s son, John Siner, was designated as her health care representative and had power of attorney."

"Upon Geraldine’s admission to Kindred, and several times thereafter, John informed . . . Geraldine’s attending physician, that Geraldine was to be a ‘full code’ patient. On November 16, 2007, Kindred’s Ethics Committee decided to make Geraldine a No Code/Do Not Resuscitate (“DNR”) patient, meaning that Kindred staff would not attempt to resuscitate her in the event that she went into respiratory or cardiac arrest (otherwise known as “coding”)."

"The Ethics Committee did not receive approval from John or any other family member to change Geraldine’s status in this manner. Geraldine’s health continued to decline over the following two weeks and Kindred declined to keep Geraldine on ‘full code’ status despite her family’s protests."

Expert Testimony
Plaintiff's expert Timothy Pohlman opined both that the hospital was negligent and that this negligence caused Siner's death.

"Kindred’s Ethics Committee recommended over-riding the wishes of the family and instructions of the patient’s medical representative for full treatment, and instituted Do Not Resuscitate (DNR) order, which ruled out such alternative treatments."

"Gerri Siner was also suffering from over-whelming infection, and septic shock at the time of intake. There is no documentation produced for me that indicate SCCM Surviving Sepsis Guidelines, . . . were followed . . . . These guidelines were not followed apparently because the patient was under a DNR order."

"Full damages and suffering that more likely than not resulted from re-prioritization of treatment modalities for Gerri Siner based on her existing ‘DNR’ order that was left in place without full agreement and consent of her Surrogate decision makers . . . ."

Appellate Ruling
The trial court granted summary judgment n favor of Kindred Hospital, finding the family had failed to introduce any evidence on causation.  The appellate court reversed, because Pohlman's testimony does create a disputed fact as to causation

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08/29/2015

Kevorkian "Very Still Life" [EOL in Art 110]

In "Very Still Life," Jack Kevorkian's message, "though somewhat capricious, nebulous and indefinable, is clearly underscored by intense feeling. Brilliant colors highlight the melancholoy age-old balance between the warmth of life and the iciness of d...

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08/29/2015

Supreme Court of Nevada Asked to Determine Brain Death Standards

Earlier this month, the Supreme Court of Nevada ordered a hospital to continue physiological support for a dead woman pending briefing, argument, and adjudication.  (I summarize the lower court proceedings here.) Today, the family filed its openi...

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08/28/2015

Minnesota Board of Medical Practice at Hamline

Join the Minnesota Board of Medical Practice at Hamline on September 12 for some educational sessions on health law.

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08/28/2015

The Changing Definition of What Is ‘Brain Dead’

Healthline News has just posted a nice new review of the debate over brain death.  It is not 100% accurate.  But it is a lucid, comprehensive, lay presentation of the issues.  

I love this quote from the distinguished critical care specialist and ethicist John Luce: " The brain dead people are not as dead as we once thought they were, in the overall biological sense."

The article also notes that Calixto Machado is working on a paper, to be published before the end of the year, which will propose a new category of consciousness to describe Jahi McMath’s as-yet-unseen circumstances.

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08/28/2015

Medicine Holding Back Death [EOL in Art 109]

The buff man of medicine holding back death itself at Fulton County Health Services in Atlanta.  Are we still so confident?

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08/27/2015

Is ICU Treatment Inappropriate? Clinicians Now Have Guidelines

Medical Ethics Advisor has just posted an article on the new "Official ATS/AACN/ACCP/ESICM/SCCM Policy Statement: Responding to Requests for Potentially Inappropriate Treatments in Intensive Care Units."  There are comments from me, Gabe Bosslet...

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08/27/2015

Child’s Garden for the ICU [EOL in Art 108]

Lisa Austin, Child's Garden for the ICU, 2001 (casters, steel, pine, plastic laminate, electric light, 6 x 10 x 10 ft).

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08/26/2015

Original Art in the ICU Waiting Room [EOL in Art 107]

Ulla Darno donated this piece for the new ICU Waiting Room at Columbia Memorial Hospital in Hudson, NY with hopes of providing a more peaceful and soothing environment to others during times of stress.  

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