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Author Archive: Thaddeus Mason Pope

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08/19/2014

Minnesota v. Final Exit Network – Assisted Suicide Case Resumes

The Minnesota assisted suicide case against the Final Exit Network begins again at 9:00 a.m. on September 8, 2014, in the Dakota County Judicial Center in Hastings. 

In June 2014, the Supreme Court of Minnesota denied the Stat…

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08/18/2014

Nursing Homes Rank as Worst Setting For End-of-Life Care

Reported end-of-life care experiences are typically worse in the nursing home setting, according to the latest results of a recent CMS survey developed and field tested by RAND.

The Hospice Experience of Care Survey measured experiences of patients an…

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08/11/2014

"Critical Gaps" in Legal Knowledge of Doctors Practicing End-of-Life Medicine

Queensland researchers led by Ben White at the Australian Centre for Health Law Research, Queensland University of Technology (where I’ll be tomorrow), have just published research in the Medical Journal of Australia demonstrating “critical gaps in the legal knowledge of many doctors who practise end-of-life medicine.”


The study focused on (1) the validity and effect of advance directives and (2) the authority of substitute decisionmakers.  The results show that physicians do not
possess sufficient legal knowledge:

  • to determine whether an advance directive presented to them is valid. 
  • to determine whether they are legally obliged to follow a directive that refuses treatment in a situation when providing treatment is clinically indicated. 
  • to determine the legally authorized decisionmaker  where there are various people who have an interest in the well-being of a patient

I am sure that U.S. results would be the same or worse.  The authors rightly conclude that doctors’ “lack of legal knowledge places their patients’ interests and rights at risk
— and them at legal risk.”

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08/09/2014

Over-Optimistic Portrayal of Life-Supporting Treatments in Newspapers and Internet

Several Taiwanese researchers have just published a new study:  ”Over-Optimistic Portrayal of Life-Supporting Treatments in Newspapers and on the Internet:  A Cross-Sectional Study Using Extra-Corporeal Membrane Oxygenation as an Example.”


From the article’s conclusion:  Newspapers and the Internet have the potential to influence patients’ knowledge and attitudes toward medical decision-making by providing over-optimistic medical information through the following ways: 

  1. First, the mass media tend to attract the public’s attention by reporting the positive outcome of an important breakthrough in clinical medicine
  2. Second, the mass media tend to report patients who survive to hospital discharge, rather than those who die during hospital stay
  3. Third, the survived patients and their stories are more likely to be duplicated in newspapers and on Internet web pages than those who die during hospital stay.

Newspaper readers and Internet users may, therefore, mistakenly believe that ECMO can usually rescue patients from all life-threatening conditions.  However, ECMO, similar to other aggressive LST such as CPR, is ethically appropriate to be initiated on patients with reversible diseases, not on those with irreversible diseases. 

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08/08/2014

Hospitals Should Let More Elderly Patients Die

In an interview with BBC-4, consultant cardiologist James Beattie (Heart of England NHS Foundation Trust in Birmingham) argues that hospitals should let more elderly patients die.  

Several papers report on the radio inte…

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08/07/2014

Technology Helps Advance Care Planning – Universal Advance Digital Directive

A radio news report, yesterday, reviews Texas-based My Directives and its Universal Advance Digital Directive (uADD).

Easy to Create
MyDirectives makes it easy to create a state-of-the-art emergency medical directive.  You can answer qu…

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08/06/2014

Less than Half of Mayo Clinic Heart Surgery Patients Have Advance Directives

Less than half of the patients who underwent a risky heart surgery at the Mayo Clinic between 2008 and 2012 completed advanced directives. (JAMA Internal Medicine 8/4/14)Aortic Stenosis
Mayo researchers focused on patients with aortic stenosis, which o…

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08/05/2014

Health Care Reform Implementation in Minnesota: Mission Advanced But Not Accomplished

A valuable conference on October 24, 2014 in Saint Paul:  ”Health Care Reform Implementation in Minnesota: Mission Advanced But Not Accomplished.”

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08/05/2014

People First Language Legislation

Last week, Delaware enacted H.B. 416.  The legislation creates no new rights or duties.  But like new legislation in many other states, it improves the vocabulary and terminology in existing law relating to people with disabilities.  



People First Language (“PFL”) legislation is part of a national movement to promote dignity and inclusion for people with disabilities.  PFL specifies that the order of terms used to describe any individual places the person first, and the description of the person second.  For example, when using PFL, outdated terms such as “the disabled” would be phrased as “persons with disabilities.”  This language emphasizes that individuals are people first, and that their disabilities are secondary.


In compliance with PFL guidelines, the new Delaware law amends current references to persons with disabilities throughout the Code by placing the person first and the disability second.  


Also pursuant to PFL, the new Delaware law removes offensive and/or insensitive language from the Code and replaces that language with respectful language.  For example, the Act replaces antiquated and offensive terms such as “mental retardation” and “mental illness” with more appropriate terms like “intellectual disability” and “mental condition,” respectively.
  

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08/04/2014

UK Quality Review: Many Patients Not Offered DNAR Option

Last week, the Local Clinical Commissioning Groups, the Leicestershire Partnership NHS Trust and the University Hospitals of Leicester NHS Trust published an innovative “quality review” examination of the health system in Leicester, Leicestershire…

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