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Author Archive: Thaddeus Mason Pope, JD, PhD

About Thaddeus Mason Pope, JD, PhD

02/19/2017

UK Court Ruling for Clinicians in Medical Futility Dispute

As we explained in Chest last year, UK courts have issued dozens and dozens of published opinions in medical futility conflicts.  This provides significant guidance and clarity as to how these cases should be resolved.   The latest of these ...

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02/18/2017

Becoming Mr. Buckley: Intimate End-of-Life Portrait

CBC News has a compelling story on photographer Dan Culberson's moving photo essay of father-in-law's battle with cancer.

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02/17/2017

Religion and Futility in the ICU

The University of Oxford Faculty of Philosophy are hosting an event on Monday, May 8, 2017:  "Religion and Futility in the Intensive Care Unit."  This is a half-day seminar exploring issues around religion, pluralism and medical ethics.

A child is critically ill in the intensive unit. Doctors believe that the child’s prognosis is very poor and that treatment should be withdrawn. However, her parents do not agree. They say that it is contrary to their religion to stop treatment.

How often is religion a source of disagreement about treatment in intensive care? What are the views of major religions about withdrawing treatment in intensive care?

Should religious requests for treatment be treated differently from secular requests? Should religious preferences for treatment count in a child? Should religious views be accommodated when providing scarce and expensive medical resources?

Guest Speaker
  • Professor John Paris S.J. (Professor of Bioethics, Boston College)

Speakers/ Panel Participants
  • Joe Brierley
  • Sarah Barclay
  • David Jones
  • John Wyatt
  • Siddiq Diwan
  • Dominic Wilkinson

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02/16/2017

Jahi McMath – Hearing to Unseal 2013 Records

The Alameda County Superior Court is holding a hearing on Thursday afternoon to determine whether to unseal medical records from the 2013 disputes over whether Jahi McMath was brain dead.   Judge Pulido already issued his tentative ruling&nb...

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02/16/2017

6th International Conference on Advance Care Planning and End of Life Care (ACPEL)

The Covenant Palliative Institute invites you to the 6th International Conference on Advance Care Planning and End of Life Care (ACPEL) bringing together leading scientists and practitioners from around the world to share the latest research and education.

Taking place in the picturesque alpine town of Banff, Alberta, Canada, the conference will focus on the theme of Conversations Matter – a critical look at the importance of effective, ongoing conversations regarding the quality of Advance Care Planning (ACP) programming and the ethical, economic, and social implications of ACP policies and legislation.

For more information please visit www.acpel2017.org

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02/16/2017

Kay Hodges – Practicing Nurse at 97 Years Old

Okay, this has nothing to do with end-of-life liberty or law.  But this is such an inspiring story that I just had to share.  Kay Hodges still works as a nurse in New Jersey at 97 years of age.

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02/15/2017

Convict Liz Van Note of Falsification & Forgery of an Advance Directive

A jury acquitted Liz Van Note of murdering her father, because there were some gaps in the evidence.   But the evidence clearly showed that Van Note forged the advance directive she used to withdraw life-sustaining treatment from her father. &nbs...

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02/15/2017

TRIAD VIII: Nationwide Multicenter Evaluation to Determine Whether Patient Video Testimonials Can Safely Help Ensure Appropriate Critical Versus End-of-Life Care

Ann Denny's image on recording healthcare directives
It was a real pleasure to be part of this project on adding video testimonials / messages to advance directives.  This was released today in the Journal of Patient Safety.  This is the 8th in the series of TRIAD articles - The Realistic Interpretation of Advance Directives.



Objective: End-of-life interventions should be predicated on consensus understanding of patient wishes. Written documents are not always understood; adding a video testimonial/message (VM) might improve clarity. Goals of this study were to (1) determine baseline rates of consensus in assigning code status and resuscitation decisions in critically ill scenarios and (2) determine whether adding a VM increases consensus.



Methods: We randomly assigned 2 web-based survey links to 1366 faculty and resident physicians at institutions with graduate medical education programs in emergency medicine, family practice, and internal medicine.  Each survey asked for code status interpretation of stand-alone Physician Orders for Life-Sustaining Treatment (POLST) and living will (LW) documents in 9 scenarios. Respondents assigned code status and resuscitation decisions to each scenario. For 1 of 2 surveys, a VM was included to help clarify patient wishes.



Results: Response rate was 54%, and most were male emergency physicians who lacked formal advanced planning document interpretation training. Consensus was not achievable for stand-alone POLST or LW documents (68%–78%noted “DNR”). Two of 9 scenarios attained consensus for code status (97%–98% responses) and treatment decisions (96%–99%). Adding a VM significantly changed code status responses by 9% to 62% (P ≤ 0.026) in 7 of 9 scenarios with 4 achieving consensus. Resuscitation responses changed by 7%to 57%(P ≤ 0.005) with 4 of 9 achieving consensus with VMs.



Conclusions: For most scenarios, consensus was not attained for code status and resuscitation decisions with stand-alone LW and POLST documents.  Adding VMs produced significant impacts toward achieving interpretive consensus.


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02/14/2017

Interactive Map of Advance Directive Laws

The Gitenstein Institute for Health Law & Policy at Hofstra University School of Law has launched a longitudinal, interactive dataset on advance care planning law.  Users can now interact with this database, presented in the form of a clickab...

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02/13/2017

Appeals Court to Rule on California "Medical Futility" Law

In 2016, the Alameda County Superior Court issued its judgment in CANHR v. Smith.  It upheld most of a challenge to the 1418.8 procedure for making healthcare decisions on behalf of incapacitated patients without surrogates. Basicall...

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