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11/18/2018

Brain Death Religious Exemptions – Three Cases Seeking Constitutional Rights

While there were were five or more North American lawsuits, this year, seeking religious exemptions from brain death, now there are only two. This month, the Ontario Court of Justice has dismissed the case of Shalom Ouanounou not only because he ...

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11/17/2018

Avoiding Advanced Dementia with a VSED Directive

Anyone who has taken even a cursory look at the medical and bioethics literature knows that leaving advance instructions to stop food and fluids by mouth is complicated.  Several organizations have developed and published planning tools. But thei...

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11/16/2018

BioethicsTV (November 13-16): #TheGoodDoctor, #ChicagoMed

by Craig Klugman, Ph.D.

Jump to The Good Doctor (Season 2; Episode 7): Directed donation; Jump to Chicago Med (Season 4; Episode 8): DNR Tattoos and Ethics Committees

As many of our favorite medical dramas head to their fall finales, they focused more on sentimental stories in the personal lives of characters, or feel good cases that did not raise any ethical issues.

The Good Doctor (Season 2; Episode 7): Directed donation

The ethical issue in this week’s episode is located in a storyline about a man who comes to the ED after injuring himself with a nailgun. One nail punctures his kidney which has to be removed but, by a genetic fluke, the man was only born with one kidney.…

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11/16/2018

Wrongful Living – Noncompliance with Advance Directives

Fredrick E. Vars and Alberto Lopez at the University of Alabama School of Law have posted a copy of their article forthcoming in the Iowa Law Review: "Wrongful Living."

"Executing an advance directive that specifies a patient’s wishes regarding end-of-life medical care is an exercise of self-determination – a conscious choice about the degree and type of medical intervention one wishes to receive under end-of-life circumstances."

"Empirical studies, however, consistently report that healthcare professionals fail to comply with advance directives; violations of a patient’s interest in self-determination are alarmingly common. From a practical perspective, the conduct of either patients or healthcare professionals may make an advance directive unavailable, which results in noncompliance. Legally, courts have historically rejected claims for “wrongful living” associated with the prolongation of life that results from unwanted medical intervention. As a result, healthcare professionals fear the liability threatened by a wrongful death claim more than the legal exposure risked by keeping an individual alive despite a contrary mandate in an advance directive."

"In response to practical concerns regarding availability, this paper proposes the creation of a nationwide registry of advance directives and argues that sanctions for violations of professional responsibility as well as the risk of liability for legal malpractice encourage utilization of the proposed registry."

"To realign the skewed legal incentives, this paper argues that the compensable harms associated with battery and negligence claims filed in lieu of “wrongful living” claims should include the loss of enjoyment of life. Because damages for loss of enjoyment of life are rarely mentioned by courts or scholars in the context of violating advance directives, this paper describes loss of enjoyment of life damages and argues that such damages should be compensable in the same manner that tort law compensates for similar injuries that lack an objective market value."

"In combination, the practical and legal proposals incentivize compliance with an advance directive and thereby expand the protection afforded a patient’s interest in self-determination."


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11/16/2018

Ethics and Society Newsfeed – November 16, 2018

  Climate Change Ethics Death toll rises to 56 in California wildfires “The death toll from the wildfires burning in Northern and Southern California has risen to 56 people, authorities announced, making it the deadliest wildfire in a century. An additional 287 people have been assigned to comb through the rubble for bodies, authorities told […]

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11/15/2018

A Bit More on “The Children We Want”

By Jon Holmlund   The Wall Street Journal recently asked “Is it ethical to choose your baby’s eye color?”  This can’t be predicted precisely, yet, because the inheritance involves several genes, but in principle it’s at least possible to play the odds by trying to predict the probability of eye color.  The article in question …

Continue reading "A Bit More on “The Children We Want”"

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11/15/2018

#InMyLane: Gun Violence and an Ethical Health Care Response

by Craig Klugman, Ph.D.

Since January 1, 2018 through November 15, the United States has seen 311 mass shootings that have killed 339 people and injured 1,249. The Centers for Disease Control & Prevention (CDC), shows that gun deaths are on the rise (mass shootings, all shootings, accidents, suicides, etc.). Shootings are the third leading cause of death in children aged 10-19 years and are responsible for 74% of all homicides. Having a gun in the home is a risk factor for death by gun whether accidental, deliberate, or unintended (a person with Alzheimer’s, a child playing).  According to the Harvard Injury Control Center, there are 265 million guns in the hands of civilians (the entire US population is about 320 million).…

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11/15/2018

A Patient Complained about the Cost of Her Medical Care. Here’s How Her Doctor Responded.

The oncologist had prescribed Xgeva hoping it would strengthen her bones while also delaying the progression of Angela Kahn’s breast cancer. But Kahn (a pseudonym) couldn’t get over the price of the drug. Before the oncologist had a chance to … Continue reading

The post A Patient Complained about the Cost of Her Medical Care. Here’s How Her Doctor Responded. appeared first on PeterUbel.com.

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11/15/2018

Hospital Compensates Parents for Turning Off Baby’s Life Support Without Consent

The County Durham & Darlington NHS Foundation Trust has offered a cash settlement to a couple alleging that clinicians at Darlington Memorial Hospital unilaterally withdrew life support from their newborn baby, Ivy, without either their knowledge o...

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11/14/2018

MAID in New Jersey – New Video Features 2 Nurses Disabled by Life-Shortening Diseases Urging Lawmakers to Act

Compassion & Choices today released its second video in a digital video ad campaign featuring passionate advocates of New Jersey’s Aid in Dying for Terminally Ill Act (A1504, S1072) urging the state Assembly and Senate to pass the bill before the end of year. Dec. 17 is the last scheduled voting day for the legislature.

The ads will continue until lawmakers enact the Aid in Dying for the Terminally Ill Act into law. The new video features two sisters who are nurses disabled by life-shortening diseases. They urge New Jerseyans to write their lawmakers in support of the legislation and to bring it to the floor for a vote.

“I've had 18 surgeries. I plan to fight my illness for as long as I can. I enjoy life,” says 61-year-old Clark resident Laurie Wilcox, LPN, who has suffered from rheumatoid arthritis for 30 years that has invaded her lung tissue and requires an oxygen tank most of the day to breathe. “At the end stage of my disease, I do not want to suffer through air hunger in the very last days of my life. Please urge New Jersey lawmakers to bring this legislation to the floor for a vote now.”

“I have two small, small grandchildren that I love to death,” says Hamilton Township resident Melissa Wilcox, RN, who suffers from small cell lung cancer, the most deadly of all lung cancers. “I don't want to die, but I'm going to. I'd like to have the opportunity to do it in my own way, at home, with my family and friends around me. I need the lawmakers to act right now because I may not have tomorrow.”

A 2-1 majority (63% vs. 29%) of New Jersey voters, including most Protestants (73%), Catholics (64%) and other non-Protestant residents (59%), support medical aid in dying, according to the most recent state poll on the issue by Rutgers-Eagleton. Major newspapers statewide have endorsed the Aid in Dying for Terminally Ill Act.

“We have the votes now to pass this popular, six year-old bill in the Assembly and Senate,” said Corinne Carey, New Jersey campaign director for Compassion & Choices. “Lawmakers should honor the wishes of the vast majority of their constituents and pass this bill before any more terminally ill New Jerseyans die in needless agony because they did not have this option.”

Medical aid in dying is authorized in Washington, D.C. and 7 states: California, Colorado, Montana, Oregon, Vermont, Washington, and starting on Jan. 1, in Hawai’i. Collectively, these jurisdictions represent nearly 1 out of 5 Americans (19%) and have 40 years of combined experience safely using this end-of-life care option.



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