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05/22/2018

Care Dis-integration

The May 3rd edition of the New England Journal of Medicine brings us a powerful story. It is a tale of a patient, named Kenneth, written by his physician brother. Central to the story is a delay in diagnosis, brought on by unfamiliarity with the patient as a whole person, biases against those with mental illness, presumptions and other errors familiar to those of us... // Read More »

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This entry was posted in Health Care and tagged , , , . Posted by Tom Garigan. Bookmark the permalink.

05/22/2018

The Land of the Gagged and the Home of the Complicit: Domestic Abortion Gag Rule is Unethical

by Craig Klugman, Ph.D.

On his fourth day in office, Trump reinstated the Mexico City Rule. The MCR was originally declared by Ronald Reagan in 1984 to prohibit U.S. federal funds from going to non-governmental health organizations if they provide, promote, refer, or mention abortion services unless abortions were given at a separate facility. Last week, Trump announced that he was going to issue a domestic gagrule that would prohibit health care providers who receive federal funding from performing or mentioning abortion as an option to women. In other words, he was going to bring the gag rule home.…

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This entry was posted in Featured Posts, Politics, Reproductive Ethics and tagged , , . Posted by Craig Klugman. Bookmark the permalink.

05/22/2018

BioethicsTV (May 14-22): #TheResident, #ChicagoMed

by Craig Klugman, Ph.D.

The Resident (Season 1; Episode 14): Treating Loved Ones; Chemo for Healthy Patients ; Chicago Med (Season 3; Episode 20): Doctor and jury

The Resident (Season 1; Episode 14): Treating Loved Ones; Chemo for Healthy Patients

In the season finale, we learn that Hunter has been telling healthy people that they have cancer (when they do not) and giving them chemotherapy. She is committing Medicare fraud and also artificially bumping her success rates at curing cancer. Pravesh informs Lily, a frequent flyer, that she does not have cancer and is a victim of Hunter. The residents tells Bell that they have informed the FBI of the problem and they suggest he suspend Hunter immediately.…

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This entry was posted in BioethicsTV, Featured Posts, professional ethics. Posted by Craig Klugman. Bookmark the permalink.

05/22/2018

California AG Emergency Request to Reverse Court Ruling to Invalidate Medical Aid-in-Dying Law

The California attorney general has filed an emergency request with the state court of appeals to reverse a lower court ruling to invalidate the End of Life Option Act. The End of Life Option Act remains in effect until further notice.


Similar to laws in Washington, D.C. and six other states, the California law gives mentally capable, terminally ill adults with six months or less to live to the option to request prescription medication they can decide to take to end unbearable suffering and die peacefully in their sleep.


Last Tuesday, Riverside County Superior Court Judge Daniel Ottolia invalidated the law because he claimed the legislature violated the state constitution by passing it during a special session limited to health care issues. He gave Attorney General Xavier Becerra five days to file the emergency request to reverse his ruling in the case, Ahn vs. Hestrin — Case RIC1607135.


"The enactment fell within the scope of the special session called, in part, to consider efforts to 'improve the efficiency and efficacy of the health care system ... and improve the health of Californians,'” says the attorney general’s appeal filed in the 4th District Court of Appeal. "As the Governor indicated, the Act deals with pain, suffering, and the comfort of having the health care options afforded by the Act."


“We thank Attorney General Becerra for filing his emergency request to reverse the lower court’s ruling that seeks to take away the peaceful option of medical aid in dying for terminally ill Californians,” said John C. Kappos, a partner in the O’Melveny law firm representing Compassion & Choices, which led the campaign to pass the law. “Ultimately, the End of Life Option Act is constitutional because Gov. Brown would have not have signed the law if it fell outside the scope of his proclamation for the special session.”


Polling shows 76 percent of Californians across the political and demographic spectrum support medical aid in dying. This majority support includes 82 percent of Democrats, 79 percent of independents, 67 percent of Republicans, 75 percent of whites, Latinos and Asian Americans, and 52 percent of African Americans.


“The most important message for terminally ill Californians and their doctors is that the law remains in effect until further notice, so terminally ill patients can still die peacefully, at home, surrounded by their loved ones,” said Kevin Díaz, national director of legal advocacy for Compassion & Choices, which filed an amicus brief. “We know this legal battle is far from over, but ultimately justice in the California court system will prevail.”


“Words cannot express the gratitude and relief that I feel thanks to this action by Attorney General Becerra,” said Matt Fairchild, a 48-year-old, retired Army staff sergeant in Burbank who advocated for the law and takes 26 medication to manage his symptoms from terminal melanoma that has spread to his bones, lungs and brain. “Knowing I still have the option of medical aid in dying if my suffering becomes intolerable brings me comfort because I will not have to endure a needlessly agonizing death.”


“As a physician, being licensed in California since 1979, I have witnessed patient's suffering in death, along with the vicarious suffering of their families in attendance,” said Dr. Thomas Cummings, medical director for A Gift of Hospice… an Interim HealthCare Company in San Diego. “It has been such a blessing to be able to prescribe End of Life Option Act medications and see first-hand the remarkable difference it can make in this very important transitional phase in life.”


Last June, Compassion & Choices released a report estimating that 504 Californians have received prescriptions for medical aid in dying since it took effect on June 9, 2016. Last July, the California Department of Public Health released a report showing 191 terminally ill Californians received prescriptions from 173 doctors for aid-in-dying medication during the nearly seven month period from June 9, 2016 until Dec. 31, 2016; 111 of those individuals (58%) decided to self-ingest the medication.


"I feel pain for the people who will die suffering during this uncertain period while judges and lawyers hold their right to a dignified end in the balance," said Dr. Lucille Ridgill, a board-certified hospice and palliative care physician in Torrance who is a member of Compassion & Choices African-American Leadership Council. "I urge those responsible to make the humane decision and allow individuals the right to their own lives."


“I'm heartbroken for all the people who might not be able to use the End of Life Option Act, which allowed my sister Betsy to die on her own terms and saved her from the prolonged suffering she was sure to face from ALS,” said Kelly Davis, who lives in San Diego County. “I hope the court of appeals will do the right thing and reverse this decision to invalidate the law.”


“This new development means the world to me because I have kept my solemn promise to my wife Brittany to ensure terminally ill Californians have the option for a gentle death,” said Dan Diaz, husband of Brittany Maynard, a 29-year-old woman from Contra Costa County, who had to move to Oregon in 2014 to utilize its medical aid-in-dying law because California had not passed its law yet. “I know our opponents will never rest, but neither will I, until I know this law is safe and secure.”


“I thank my fellow Latino brother Xavier Becerra for his efforts on behalf of terminally ill Californians, like the ones I worked with very closely to pass the law,” said Dolores Huerta, a civil rights activist from Bakersfield who is a member of Compassion & Choices Latino Leadership Council. “I helplessly watched my mother die in agony from breast cancer because she did not have this palliative care option, so I do not want to see anyone else suffer like she did.”  


“This legal struggle reinforces my faith in God because I know in my heart that he does not want his children to suffer needlessly at life’s inevitable end,” said Rev. Dr. Ignacio Castuera, a Methodist minister in Claremont who is a member of Compassion & Choices Latino Leadership Council. “I pray he gives the court of appeals the same wisdom it displayed today when they ultimately decide the merits of this case.”


California is one of seven states — including Colorado, Montana, Oregon, Vermont, Washington, and Hawai‘i — as well as the District of Columbia, that have authorized medical aid in dying. Collectively, these eight jurisdictions represent nearly one out of five Americans (19%).


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This entry was posted in Health Care and tagged . Posted by Thaddeus Mason Pope, JD, PhD. Bookmark the permalink.

05/22/2018

Controversy Persists as States, Courts ‘Question, Push Back, and Challenge’ Brain Death Criteria

Medical Ethics Advisor suggests that "ethicists must keep close tabs on changing legal landscape" regarding brain death. A new article in the May 2018 issue interviews Ken Goodman, Ariane Lewis, and me.  

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This entry was posted in Health Care and tagged . Posted by Thaddeus Mason Pope, JD, PhD. Bookmark the permalink.

05/21/2018

Taquisha McKitty’s Father Reflects on Legal Battle to Keep Brain Dead Daughter in Hospital

In this video Taquisha McKitty’s father reflects on his legal battle to keep his brain dead daughter in the hospital.


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This entry was posted in Health Care and tagged . Posted by Thaddeus Mason Pope, JD, PhD. Bookmark the permalink.

05/21/2018

Brain Death and Treating Corpses (podcast)

I recently joined Nicolas Terry and Frank Pasquale for the 139th episode of their podcast series, THIS WEEK IN HEALTH LAW. They distribute across many platforms including Podbeam and YouTube. We discussed grave and complex problems in end of life care...

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05/21/2018

41st Annual Health Law Professors Conference ASLME

Coming up in just over two weeks:  The American Society of Law Medicine and Ethics' 41st Annual Health Law Professors Conference at both Case Western Reserve School of Law and the Hilton Downtown Cleveland.  This is the oldest and largest co...

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05/20/2018

End Well 2018 Conference

End Well 2018 is convening on December 6, 2018, in San Francisco at the SFJAZZ Center.  It will be an immersive day of thought-provoking and action-inspiring speakers, ideas and activities designed to help transform the end of life experience and...

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This entry was posted in Health Care and tagged . Posted by Thaddeus Mason Pope, JD, PhD. Bookmark the permalink.

05/19/2018

2018 ACP Michigan Conference – Shared Decision Making and Advance Care Planning: Using Decision Aids to Improve Patient Safety

Join me at the 2018 ACP Michigan Conference, this October, in Lansing. 

My main talk will be "Shared Decision Making and Advance Care Planning: Using Decision Aids to Improve Patient Safety." I will also discuss advance directives for dementia.  

Wednesday, October 10, 2018
PACE Pre-Conference     

1:00 pm-1:15 pm                      
Welcome and Introduction
James Kraft, MTh, Henry Ford West Bloomfield

1:15 pm-1:45 pm                      
Opening Address: Defining Advance Care Planning
Kate LaBeau, RN, Upper Peninsula Health Plan

1:45 pm-2:15 pm                      
LifeCircles Presents: How One PACE has Implemented ACP
Luke Reynolds, LMSW, LifeCircles PACE

2:30 pm-3:20 pm                    
Small Group Facilitated Discussions: Address ACP Process in PACE
Mary Naber, MBA, Southeast Michigan PACE

3:20 pm-3:40 pm                    
Small Group Report-out: Return and Report
Dr. Graddy-Dansby, Southeast Michigan PACE

3:40 pm-4:00 pm                    
Discuss Next Steps
Mary Naber, MBA, Southeast Michigan PACE

Thursday, October 11, 2018

8:00 am                                   
Registration for conference opens
Light breakfast options

8:30 am                                   
Welcome

8:45 am-9:45 am                   
Keynote: Shared Decision Making and Advance Care Planning: Using Decision Aids to Improve Patient Safety 
Thaddeus Pope, JD, PhD, Director of the Health Law Institute and Professor of Law, Mitchell Hamline School of Law  

9:45 am-10:00 am                
Refreshments in the Royale Atrium/Alcove

10:00 am-10:50 am              
Breakout Session A

11:00 am-11:50 am                
Breakout Session B

11:50 am-12:50 pm                
Lunch in the Royale Atrium/Alcove

12:50 pm-1:40 pm                
Breakout Session C

1:40 pm-2:15 pm                    
Posters/Sponsors

2:15 pm-2:30 pm                   
ACP Michigan Network Update - Carolyn Stramecki, MHSA, Honoring Healthcare Choices - Michigan

2:30 pm-3:30 pm                  
Keynote: The Truth of the Experience: How We Can Get to a Deeper Understanding of Our Patient's Wishes
Ray Barfield, MD, PhD, Professor of Pediatrics, Duke university; Director of Medical Humanities, Trent Center for Bioethics, Humanities and History of Medicine         

3:30 pm-3:45 pm                  
Closing

General Attendees: Evening on own OR sign up for the Thursday Evening Networking Reception with speakers and planning committee. If you are interested, please sign up for the conference AND reception. Additional fee is required. 

Thursday Evening Networking Reception for Speakers, Planning committee and those who Pre-registered.

6:00 pm-8:00 pm                 
Heavy hors d'oeuvres and cash bar

Friday, October 12, 2018

8:00 am-8:30 am                 
Registration for Day 2 Attendees; light breakfast options

8:30 am-9:20 am                 
Breakout Session D

9:30 am-10:20 am               
Breakout Session E

10:20 am-10:35 am              
Refreshments in the Royale Atrium/Alcove

10:35 am-11:45 am
Keynote: A Patient’s Case for Care Coordination and ACP - Monica Ott, MD, CMD, Assistant Professor of Clinical Medicine, Department of Internal Medicine and Geriatrics, Indiana University; Medical Director of OPTIMISTIC

11:45 am                                 
Closing Comments

Post Conference

12:30 pm-1:00 pm                
Boxed Lunch for Pre-Registered Post-Conference Attendees

1:00 pm-3 pm                      
Art and Design of Successful ACP Implementation - Kate LaBeau, RN, Advance Care Planning Program  Manager, Upper Peninsula Health Plan

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This entry was posted in Health Care and tagged . Posted by Thaddeus Mason Pope, JD, PhD. Bookmark the permalink.