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01/12/2017

Who Has the Right to Turn Off Donald Trump’s Artificial Heart?

In one of his recent Gresham College lectures, Professor Martin Elliott discusses  how with today's medical technology and Donald Trump's money, he might be able to prolong his biological life indefinitely.   Is that appropriate?  Who s...

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

01/11/2017

The Cost of Being Whole: Double-Standards and Discrimination in Trans Healthcare

by Jenji C. Learn, BA

How much are your genitals worth to you? Your beard? Your breasts?

What’s a reasonable price for them? It’s not like you really need them, right?  They aren’t essential organs. They’re purely cosmetic- superficial!

If an accident or a malicious act cost you one of those things, you certainly wouldn’t expect your health insurance to cover it, or expect anyone to feel any sympathy for you. Why should they? That’s your responsibility, and you should pay out of pocket, because after all, you can live just as well without any of that stuff, surely.

If you found what I just said to be shocking, grotesque, callous, offensive, or positively inhuman… then so too must you apply those same words to describe the status of healthcare for trans and intersex people in America.…

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This entry was posted in Featured Posts, Health Policy & Insurance, Justice, professional ethics and tagged , , . Posted by Jenji Learn. Bookmark the permalink.

01/11/2017

Flatulence and Elections

Approximately once a month I open my schedule and see that my first task of the day is to write a post for the Alden March Bioethics Blog, Bioethics Today. The first part of this task is to determine what to write about. Sometimes that is the most difficult part of the job. I try to give myself fairly wide discretion in choice of topics but this is a bioethics blog so I do try to be conscientious about finding some relationship between the topic of the blog and bioethics. Sometimes that is hard. Recently while perusing the venerable Washington Post I came upon an article that I felt I had to write a blog about.

It also happened that today was the day that my calendar told me it was time to write a blog. So here goes.

It was reported today that there was a fire in the operating room April 15 during a surgical procedure. An unidentified woman was undergoing a surgical procedure on the cervix with a laser. To make a long story short, the woman passed gas, the laser ignited the flatulence and the surgical draping caught fire.

I was attracted to this article because I used to be a young boy (this was a very long time ago) and all young boys believe that everything about farts is funny and entertaining. It was even more entertaining when the flatulence was ignited. Alas when I first saw the article I thought it would be funny but it was not. The woman was seriously burned.  This no longer seemed like a good topic for a blog and I left it incompletely written and unpublished.

While this happened months ago it is current again. At least in my thinking it has become current. The reason for this is that sometimes things that start out seeming funny or absurd become serious issues. I admit that only months ago I thought that the fact that a certain individual was running for president was both funny and absurd. Now he has been elected and it seems neither funny nor absurd. It seems very serious indeed.

So now in my mind the presidential election process evokes thoughts of a woman who was seriously burned in a fire ignited by her own flatulence. I hope the nation and the world are not seriously burned by this election but I fear they will be.

The Alden March Bioethics Institute offers a Master of Science in Bioethics, a Doctorate of Professional Studies in Bioethics, and Graduate Certificates in Clinical Ethics and Clinical Ethics Consultation. For more information on AMBI's online graduate programs, please visit our website.

 

 

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This entry was posted in Health Care, Politics and tagged . Posted by Bioethics Today. Bookmark the permalink.

01/11/2017

Bishop Tutu’s Plea Prompts Personal Meditation on Assisted Suicide

By Myra Christopher
I worked late Tuesday night and was listening to NPR as I always do during my short commute home when I heard that, in celebration of his 85th birthday, Bishop Desmond Tutu announced that he supports physician-assisted suicide and “prays that politicians, lawmakers and religious leaders have the courage to support the choices that terminally ill citizens make in departing Mother Earth with dignity and love.” I was stunned.

At age 30, I decided to spend my life working to improve end-of-life care and that the way that I would do that would be by “doing ethics.” I would spend my life arguing that the seriously ill and dying have an inherent right to a “dignified death.” This year I will be 70, and I have had a long and interesting career. Over the past 40 years, the issues of euthanasia and physician-assisted suicide have been what I considered as recurring distractions from what I have thought to be really important, i.e., advancing palliative care. Bishop Tutu’s comments, however, cannot and should not be considered by any one as simply a “distraction.” I believe they are a “game-changer.”

In the late 1990s, I directed Community-State Partnerships to Improve End-of-Life Care, an $11.25m Robert Wood Johnson (RWJ) Foundation grant award program. At about the same time, Jack Kevorkian – or Dr. Death as he came to be known – came on to the public scene. At a national conference, I was asked what I thought of Dr. Kevorkian, and I said without hesitating that I thought he was a murderer and should be imprisoned.

Envisioning Other Options

After the conference, a communication officer from the RWJ Foundation asked me if I knew the data regarding public views on physician-assisted suicide. I said that, of course, I did – 50% of Americans were for it and 50% were against it. She said, “You realize that when you made the statement you did that half the audience turned you off,” and then asked me if I could imagine saying something like, “Physician-assisted suicide is something good people disagree about, but what we can all agree upon is that we must do a better job of caring for those who are seriously ill and dying so that they don’t see suicide as their only option.”

That statement made good sense to me and has served me well over the years. To clarify my personal view, I always add that I am against the “legalization” of assisted suicide but would NEVER pass moral judgment on a caring committed physician or loving family member who assisted a patient or loved one to die. Furthermore, I know that it happens all over the United States every day. Years ago, an article titled “It’s Over Debbie” was published in JAMA (Journal of the American Medical Society) in which a resident anonymously reported having euthanized a young woman in agonal pain dying of a terminal gynecological cancer. I got four calls, two of them from healthcare professionals in Kansas City, telling me that the caller was sure the event had occurred in their own hospital. 

Personal Choice and the Slippery Slope

I have shared in private conversations, however, that in certain situations, I would personally choose to end my own life and expect others to help me to do so if I were incapable of acting on my own behalf. I recognize the logical inconsistency of my thoughts and have felt hypocritical from time to time. But because so many people in the U.S. are not insured and do not have access to healthcare, especially good end-of-life care, and because we know without question that certain populations, e.g., people of color and those in lower socio-economic situations, receive less care, worse care and have poorer outcomes, I have felt that legalizing physician-assisted suicide could potentially make these people even more vulnerable…that it was just too risky. Even though the data from Oregon, the first state in the U.S. to legalize physician-assisted suicide, has not proven that to be true, my fear has been the “slippery slope,” i.e., if we allow competent people to make this choice, are we then far from deciding the same should be true for those who cannot make decisions for themselves. I still do not believe that concern is unfounded.

The Netherlands, the first country to legalize euthanasia, now allows others to make decisions about ending the lives of those who are unable to be self-determining. Furthermore, years ago, I debated this issue with Derek Humphry, Founder of the Hemlock Society, and when I asked him if he would support euthanizing people who had never been able to express their wishes, he said something like “not now.”

No Safe Harbor

Bishop Tutu
Ironically, in the early 2000s, two nurses in upstate New York who published an online newspaper called The North Country Gazette, decided that I was the leader of the euthanasia movement in the U.S. For several months, they published a “front-page” article about euthanasia and included my name in the headline. I wasn’t aware of it until I began to receive letters from children asking me why I wanted to kill their grandmother and got a couple of calls from national organizations with whom the Center was working asking me to clarify our position on euthanasia. (I should point out that the Center does not now nor has it ever had an official position on euthanasia. Members of the Center’s board and staff are not of one mind about this issue, and I suspect never will be.)

After hand-printing a few letters to children saying that I was not sure why they thought I would ever want to harm their grandmother, we learned the source of the perception. I honestly will never know why I became the target of this series. I do know, however, that it was heart-breaking to me that for nearly two years, if you Googled “euthanasia,” my name was the first thing to pop-up. 

Neither my ambivalence (or lack of intellectual clarity) nor my efforts to claim the moral high ground – or even what I thought to be clever communication strategies – had provided me a safe harbor or a pass from this debate.

A Moral Right

Now on Tuesday night, Bishop Desmond Tutu, a person who for years I have considered a global moral leader and personal hero, spoke with conviction and confidence about euthanasia as a moral right, an entitlement. 


Ethics is not about black and white. In my experience, it is clearly about trying to deal with “shades of gray.” But, from a philosophical perspective, respect for human life is not negotiable and that has been a sticking point for me. Tuesday night Bishop Tutu said, “As a Christian, I believe in the sanctity of life and that death is a part of life. I hope that when the time comes I am treated with compassion and allowed to pass on to the next phase of life’s journey in the manner of my choice.” I do too. 




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01/11/2017

Impact of Law on Medical Practice

In the latest issue of the Journal of Law & Medicine, Lindy Willmott and colleagues measured doctor's attitudes about the role of law in medical practice.   Here are a few highlights: 82% agreed or strongly agreed that "resolving disput...

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

01/10/2017

Be Wary What You Research: You Might Get Sued

by Craig M. Klugman, Ph.D.

Peter Cohen, Clayton Bloszies, Caleb Yee and Roy Gerona published an article in the journal Drug Testing and Analysis in April 2015 explaining the results of their testing of supplements. The researchers found that a compound, BPMEA, appeared in nearly half the supplement brands they examined and since neither the FDA (supplements are not currently under the purview of the FDA because they are not food products nor are they medications) nor the European Drug Agency has found BPMEA safe for human consumption, no one should purchase these supplements.

The result? Cohen and his colleagues were sued by Hi-Tech pharmaceuticals for libel and defamation of their products.…

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01/10/2017

‘Examening’ the New Year!

By Michael P. McCarthy The New Year offers a clean slate, a welcome opportunity to try something new.  Given the title of the blog, Reflective MedEd, I would like to offer a way of refocusing and reorienting oneself through reflecting on the experiences of the day.  As Hedy Wald described in her blog post, reflection […]

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01/10/2017

Chayim Aruchim – Charting Rough Waters! Torah True Guidance in End-of-Life Situations

Agudath Israel of America created Chayim Aruchim in 2010 because many of those in end of life situations often found themselves denied care by a growing trend in the medical community that limited or withheld treatment for patients who were considered ...

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

01/10/2017

How Much Does Health Insurance Cost?

Want to buy health insurance for your family? Last year, that would have cost you almost $18,000. In 1999, the cost would have been closer to $6,000. Here’s a table showing the steady rise in prices: Surprised at the $18,000 … Continue reading

The post How Much Does Health Insurance Cost? appeared first on PeterUbel.com.

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

01/09/2017

Crossing the Line: When Doctors’ Beliefs Endanger Patients’ Autonomy and Health

by Craig M. Klugman, Ph.D.

In 2016 the Illinois legislature passed and Governor Bruce Rauner signed into law Public Act 099-690 (SB 1564), an amendment to the Health Care Right of Conscience Act. This change states “It is also the public policy of the State of Illinois to ensure that patients receive timely access to information and medically appropriate care.” The change requires physicians to inform patients about legal treatment options including their factual risks and benefits, but does not require the physician to perform such services. If the hospital or physician has a conscientious objection to performing a procedure, then the patient must be referred to or transferred to someone or some facility that will.…

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