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Author Archive: Thaddeus Mason Pope, JD, PhD

About Thaddeus Mason Pope, JD, PhD

The Veterans Affairs Office of Inspector General just released an inspection report of the Oscar G. Johnson VA Medical Center in Iron Mountain, Michigan. Care coordination concerning life-sustaining treatment decisions was one of the four focus areas.

VHA requires practitioners to initiate goals of care conversations with high-risk patients—including hospice patients or their surrogates—within a time frame that meets the medical needs of the patient or at the time of a triggering event. The GOC conversations are discussion between a healthcare provider and a patient or surrogate to help define the patient’s values, goals, and preferences for care and, based on the discussion, make choices about starting, limiting, or ceasing LSTs.

The OIG found that the medical center generally complied. But it expressed concern that a new VHA requirement could mislead practitioners to only address those goals of care conversation elements that are required to be documented in the LST progress note.



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Dr. Zeke Emanuel ("the architect of the Affordable Care Act”) and Dr. Jonathan Moreno (“the quietly most interesting bioethicist of our time”) talk to Peg Sandeen about medical aid in dying in their latest MAKING THE CALL podcast.


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Dr. Zeke Emanuel ("the architect of the Affordable Care Act”) and Dr. Jonathan Moreno (“the quietly most interesting bioethicist of our time”) talk to Peg Sandeen about medical aid in dying in their latest MAKING THE CALL podcast.


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We are still waiting for the decision and opinion from the Texas Second Court of Appeals in Tinslee Lewis v. Cook Children's Hospital. The case challenges the constitutionality of the dispute resolution provisions in the Texas Advance Directives A...

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We are still waiting for the decision and opinion from the Texas Second Court of Appeals in Tinslee Lewis v. Cook Children's Hospital. The case challenges the constitutionality of the dispute resolution provisions in the Texas Advance Directives A...

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It has been professionally rewarding to co-author three policy statements on health care policy, ethics, and end-of-life care with the American Thoracic Society. All of these are available for free here. Making Medical Treatment Decisions for Unrepres...

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It has been professionally rewarding to co-author three policy statements on health care policy, ethics, and end-of-life care with the American Thoracic Society. All of these are available for free here. Making Medical Treatment Decisions for Unrepres...

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Check out this course at Cardiff University. It explores how (un)consciousness, coma and the vegetative state are represented in the media. 

This course allows you to engage with debates about the portrayal of patients and reporting of  ‘miracle’ recoveries, court cases and scientific breakthroughs. It addresses implications for family and public understandings. This course will help develop your understanding of ‘coma’ and your skills in writing for the media or being a critical media consumer or researcher, or supporting patients and their families.

I like this page which includes interviews and commentaries on key cases like Nancy Cruzan, Aruna Shanbaug, an Eluana Englaro.

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Check out this course at Cardiff University. It explores how (un)consciousness, coma and the vegetative state are represented in the media. 

This course allows you to engage with debates about the portrayal of patients and reporting of  ‘miracle’ recoveries, court cases and scientific breakthroughs. It addresses implications for family and public understandings. This course will help develop your understanding of ‘coma’ and your skills in writing for the media or being a critical media consumer or researcher, or supporting patients and their families.

I like this page which includes interviews and commentaries on key cases like Nancy Cruzan, Aruna Shanbaug, an Eluana Englaro.

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This month, the Society for Post-Acute and Long-Term Care Medicine (AMDA) became the first national organization to formally endorse and support the adoption of a national POLST form.

The national form was created because a single form—as opposed to just state-to-state form reciprocity—will make it easier, among other things:

  • For providers to recognize a POLST form and  correctly interpret and follow POLST form orders, thereby enabling them to honor patient treatment preferences
  • To conduct research and quality assurance activities, creating shared data for generalizable knowledge and ability to improve POLST
  • To more broadly educate patients and providers about POLST so the process and form are understood and appropriately implemented consistently everywhere

While not solely for emergencies, the POLST form is valuable in communicating to EMS providers whether the patient wants CPR or not and whether they want to be transported to the hospital or remain in place and made comfortable. Therefore, the POLST form itself must be immediately recognizable to all EMS providers and healthcare professionals.

“POLST exists to provide seriously ill or frail patients a tool to communicate their treatment preferences as they transition across care settings or travel throughout the United States.” (Amy Vandenbroucke, JD, executive director of National POLST).

POLST is an approach to advance care planning for patients who are considered to be at risk for a life-threatening clinical event because they have a serious life-limiting medical condition, which may include advanced frailty. The POLST process emphasizes eliciting, documenting, and honoring patient preferences about the treatments they want to receive during a medical emergency or as they decline in health. These treatment wishes are documented on a portable medical order called a POLST form.

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