Blog RSS Blog.

10/28/2014

More Secret DNR Orders in UK – Barbara Gibson

In the UK, clinicians may write a DNR order without consent, if they deem that to be in the patient’s best interest.  But clinicians must still consult with the patient or family.  In other words, they may write a unilateral DNR order.  But they may not write a “secret” DNR order.
 
Yet, as I have recounted on this blog more than a dozen times, this continues to happen.   One of the most recent cases occurred in August 2014 at Ayr Hospital.


In an apology letter to the family, the said: “I wish to offer my sincere apologies again on behalf of all the staff concerned for the distressing events you have described, and wish to reassure you that lessons have been learned and that practice around DNACPR decisions are being reviewed and improved as a matter of urgency across the organization. . . .  It is evident from the review of Mrs Gibson’s medical records, and discussions with staff involved, there were failures in communicating the medical decisions around resuscitation to Mrs Gibson and yourselves.”





Full Article

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

10/27/2014

Ebola: where is the rock concert benefit?

by Arthur Caplan, PhD and Nir Eyal, D.Phil

Ebola’s toll is rising exponentially. Millions of lives are at risk in West Africa, and panic is starting to take its toll in the rest of the world.

Normally in a crisis like this our best charitable impulses pour forth. Especially among musicians, Hollywood and artists. So why aren’t fund-raising drives taking place? Where are the rock concerts, fashion shows, triathlons we saw for famines and for AIDS? Why the extreme paucity of small private donations?

Some may think donations won’t help. Of course they would.

Donations could buy protective equipment and disinfectant for health personnel and for home care givers.…

Full Article

This entry was posted in Featured Posts, Public Health and tagged . Posted by Arthur Caplan. Bookmark the permalink.

10/27/2014

Bioethics Commission FAQs from ASBH

Last week the Presidential Commission for the Study of Bioethical Issues (Bioethics Commission) attended the American Society for Bioethics and Humanities (ASBH) annual meeting, held in San Diego, California October 16-19. Along with leading multiple presentations, the Bioethics Commission was pleased to host a booth in the conference’s exhibition hall. The exhibit featured Commission reports […]

Full Article

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

10/27/2014

Must we all die with forced hand-feeding in Advanced Dementia? Will others honor our Living Will?

A nice video by Stanley Terman reviewing the Margot Bentley case now on appeal in British Columbia.

Full Article

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

10/27/2014

Brittany Maynard Urges Palliative Care Specialist to Stop Misrepresenting Her Case

Brittany Maynard urges palliative care specialist Ira Byock to stop misrepresenting her case prior to his debate with Compassion & Choices President Barbara Coombs Lee on the Diane Rehm Show this week
.
In comments that Brittany posted on the website for Rehm’s nationally-syndicated NPR show, she denied claims by Byock and other opponents of death with dignity that Compassion & Choices is using her to advance the aid-in-dying movement. Rehm read part of Brittany’s comments during her show. 


“I am Brittany Maynard and it concerns me that Dr. Ira Byock will speak on my ‘behalf’ at all again. I watched a special on PBS where this same individual spoke about my case as though he knew personal details about me, saying some things that were quite frankly not true.


“For example, he said that a gentle death would be available to me easily through hospice, unfortunately that would be after a great length of time, with lots of suffering (physical and emotional), and loss for my young body. He is right that this is not being accomplished successfully for many terminally ill Americans on a widespread basis across our country. This needs to change too, I agree with him there.”


“But perhaps most disturbingly, Byock claimed that Compassion & Choices had somehow taken advantage of me through ‘exploitation’ and that I feel compelled to die now based on public expectations. I DO NOT, this is MY choice, I am not that weak. The day is my choice, I have the right to change my mind at any time, it is my right. I am very confident about this. This is a patient right that is critical to understanding Death with Dignity.”


“The claim of exploitation is utterly false considering I had gone through the entire process of moving, physician approval for DWD [death with dignity], and filled my prescription before I EVER even spoke to anyone at Compassion and Choices about volunteering and decided to share my story. I support the organization because I support the cause. I believe this is a healthcare right and CHOICE that should be available to ALL terminally ill Americans.”


“I made my decisions based on my wishes, clinical research, choices, discussions with physicians, and logic. I am not depressed or suicidal or on a ‘slippery slope.’ I have been in charge of this choice, gaining control of a terrifying terminal disease through the application of my own humane logic. We as a country have real issues with the way doctors are trained to speak about, educate and embrace realities of death.”


“As a terminally ill patient, I find it disrespectful and disturbing when people discuss my personal health with details that are not accurate to push an agenda. My request is that physicians speak only what they directly know to be factually true and have a right to discuss. The best change for all our community, physicians and patients, will come from us pulling together and developing policies to protect the severely ill based on honesty, education, and humane treatment of suffering.”


“I wish nothing but peace and healing for whom it is available, and a peaceful passing of comfortable choice for whom it is not.”

Full Article

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

10/26/2014

Authorship in Global Health Research

<p><span style="line-height: 19.0400009155273px;">In a recent paper published in <em><a href="http://www.biomedcentral.com/content/pdf/1472-6939-15-42.pdf">BMC Medical Ethics</a></em></span><span style="line-height: 19.0400009155273px;">, my co-authors and I argued that there are unique issues in authorship in the context of global health research (GHR).</span><span style="line-height: 19.0400009155273px;">Global health places priority on improving and ensuring equity in health worldwide. GHR is often multi/interdisciplinaryand involves large collaborative networks. Our analysis of authorship GHR applies to situations where researchers from high income countries (HICs) partner with those in low and middle-income countries (LMICs). First, let’s start by illustrating an example of a GHR research project. Let’s say that researchers wanted to study the genetics of a tropical disease. They wrote and succeeded in obtaining a U.S. National Institutes of Health funded grant. HIC researchers may bring to the collaboration scientific expertise, access to genomics/proteomic technologies, and may have been the main PI on the grant. LMIC researchers may be from a nation affected with the disease and can also provide scientific expertise, insight into local perceptions and realities, and access to the study population – the latter especially being difficult for HIC researchers given possible issues surrounding trust. Together, the team may gather epidemiological genetic data relevant to international public health interventions and also help address local needs and interests.</span></p>
<p><strong style="line-height: 19.0400009155273px; color: #34405b; font-family: Arial, Helvetica, sans-serif; font-size: 12px;">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 <a style="text-decoration: underline; color: #000099;" href="/Academic/bioethics/index.cfm">website</a>.</strong></p>

Full Article

10/26/2014

Medical Overview of Brain Death (Video)

Adam Webb at Emory provides an excellent and accessible overview of the medical and ethical issues involved in brain death in this recent webinar for the Southeast Chapter of the Society of Critical Care Medicine.

Full Article

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

10/25/2014

Making Decisions for Others – Surrogates & Unrepresented Patients (May 7-8, 2015)

Ethical dilemmas commonly arise in healthcare regarding patients who are unable to make their own medical decisions.  
  • Who is best positioned to speak for these patients, and what decisions should we allow them to make? 
  • What if the patient has no friends or close family members, or close relatives disagree on the best course of action? 
  • Should there be a limit on what parents can decide for minor children? 


Cases involving decisions by others are often the most difficult cases that health care providers confront.  Yet policies pertaining to such decisions are frequently problematic, and education for providers about these issues is rarely prioritized.


The UAMS Intensive Healthcare Ethics Workshop for 2015 aims to bring together an interdisciplinary group of scholars to share research and experiences about decision-making for others. The workshop is designed for only a limited number of participants in order to be highly interactive, and will include keynote speaker and small group sessions, as well as submitted papers and posters.   

Submit proposals here by January 12, 2015.  

KEYNOTE SPEAKER
Jessica Berg, JD, MPH
Interim Dean, Professor of Law and Biomedical Ethics, and Associate Director of the Law-Medicine Center
Case Western Reserve University

PLENARY SPEAKER
Douglas B. White, MD, MAS
UPMC Endowed Chair for Ethics in Critical Care Medicine and Director, Program on Ethics and Decision Making in Critical Illness
University of Pittsburgh Medical Center

WORKSHOP DIRECTOR
D. Micah Hester, PhD
Chief, Division of Medical Humanities, Clinical Ethicist
University of Arkansas for Medical Sciences and Arkansas Children’s Hospital

Full Article

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

10/24/2014

Surprised by Joyousness

This week, I was brought up short by a quote from a book by Malcolm Muggeridge entitled Something Beautiful for God. Muggeridge is writing about Mother Teresa and the religious congregation she founded, the Missionaries of Charity. According to Wikipedia, the Missionaries of Charity ”run hospices and homes for people with HIV/AIDS, leprosy and tuberculosis; soup kitchens; dispensaries and mobile clinics; children’s and family counselling programmes; orphanages; and schools.” Muggeridge… // Read More »

Full Article

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

10/24/2014

Do Doctors Have a Duty to Treat Patients With Ebola?

[Huffington Post] Now that two nurses treating Ebola victim Thomas Eric Duncan have themselves been diagnosed with the disease, it is time to ask: Do doctors, nurses and other healthcare professionals have a duty to treat patients? What of the unsung healthcare “workers” — hazmat teams, EMTs, transporters who wheel stretchers, lab techs who test […]

Full Article