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01/08/2017

Brain Death Deserves a Fuller and More Public Debate

Margaret Hayden won the 2016 Henry K. Beecher Prize in Medical Ethics.  Her essay, "Negotiating Ambiguities in Life and Death," has some constructive insights for the growing brain death debate.   Hayden notes that "in many ways, the ambigui...

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01/07/2017

Mayo Clinic Summer Undergraduate Program in Biomedical Ethics Research

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01/07/2017

VSED Conference in North Carolina

After October's very successful two-day conference on VSED in Seattle, I am gearing up for another one in North Carolina on April 6, 2017.  Join me and other legal and medical experts.  

7:00  Registration opens  – complimentary Continental Breakfast & Exhibits

9:00  Welcome and Introduction: keynote speaker – Thaddeus Pope, JD, PhD.
Voluntary Stopping Eating and Drinking (VSED) – it’s special place in our American culture, ethics, and law as regards End-of-Life Decision-Making.

10:00  Survey of end-of-life choices: North America versus Western Europe.

10:40 Breakout Presentations: in-depth exploration, discussion & Q&A

Morning Theme: For the Hospice-eligible patient seeking VSED nursing support: the ethical, legal, clinical issues for the patient & family caregiver

10:40-11:50   John Moskop, PhD  – Medical Bioethicist
Ethical issues– in simpler case – alternative strategies:  How might the patient and family approach the ethical issues about early onset of death with the choice of VSED?

10:40-11:50 Mark Corbett, MD – Hospice Physician
Clinical issues– in simpler case – is it generally expected with Hospice nurse support that a family caregiver can manage pain, discomforts, hygiene with VSED?

10:40-11:50   Kevin Diaz, JD  – Legal Advocate
Legal issues – various EOL legal and medical documents (ACD, HCPOA, MOST, competency exam) to perfectly or usually avoid legal controversy with VSED?

10:40-11:50   Office of the Medical Examiner
Law enforcement issues – VSED: competence, coercion, elder abuse?  How and when these issues come into focus for the Medical Examiner?

Noon  – complimentary Lunch served on the mezzanine 

1:00-4:00  Plenary session – 3 presenters – then moderated panel discussion & Q&A
Afternoon Theme:  For the UNCERTAIN case and the COMPLICATED case
Case 2:  with clinically uncertain “imminent-death” – what are the obstacles to a patient choosing to start VSED?  The practical alternatives to provide medical/nursing support.
Case 3:  with complicated questions of patient consent, mental capacity, possible coercive influence – what are the obstacles to surrogate decision-making for VSED?

1:40-2:10   Mark Corbett, MD – case 2: challenges and clinical alternatives when a competent patient chooses VSED before imminent-death.

2:10-2:40   John Moskop, PhD – case 2/3:  ethical challenges in decision-making situations such as before imminent-death or absent cognitive competence.

2:40-3:10   Thaddeus Pope, JD, PhD – case 2/3: without imminent-death or without competence – what is the surrogate decision-maker to do?  how compelling is the patient’s earlier ACD affirmation, other forms/media to show intention – now that years later they can not decide?  Can their surrogate rely upon it?  Would the court be persuaded by it?

3:25   Panel Discussion and Audience Q&A – Moderator Rosemarie Tong, PhD

4:00     Conference closing    Thanks – sponsors!  evaluations & feedback.

Evening lecture
Davidson College campus   – public is invited free-of-charge –   Davidson NC     
6:30-8:00  Thaddeus Pope, JD, PhD     
Withholding Food & Fluids in Advanced Dementia – is it ethical and legal?     

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01/07/2017

Missouri Tries Again for Simon’s Law Red Light on Pediatric Medical Futility Policies

For the third year in a row, Missouri is considering "Simon's Law" legislation, H.B. 440. Bill Kidd First, healthcare facilities "shall disclose in writing any policies relating to a patient or resident or the services a patient or resident may r...

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01/06/2017

Party politics, people’s lives

As health care financing rises yet again to the top of our national legislative agenda, some fundamental questions ought to be strongly considered. First, and most fundamental: Is some level of healthcare a right, that the government is therefore obligated to protect? Is it better viewed as a common good, like roads and fire protection services, that everybody pays for through taxes and everybody benefits... // Read More »

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01/06/2017

Are Your Healthcare Prices Outrageous? Here’s What Happens When Prices Come Out Of The Dark

They both had shoulder pain, persistent despite weeks of physical therapy. Both received MRI examinations at reputable radiology facilities, looking for things like rotator cuff tears, labral disruptions and other anatomical abnormalities. What was different was the price they paid … Continue reading

The post Are Your Healthcare Prices Outrageous? Here’s What Happens When Prices Come Out Of The Dark appeared first on PeterUbel.com.

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01/06/2017

Exercise is good for you and High Heels are not: Health Reports on the Obvious

In a quest for health news which might spark some meaningful topic worth sharing with the Bioethics community, I was repeatedly dismayed at the number of articles offering relatively little useful information at all. In fact, there seemed to be a surprising number of articles that offer scientific support for topics that might be tempting for a superficial glance, but do not add meaningfully to the much broader well-being of individuals and communities. I strongly support using any tools necessary to disseminate health information to persons who may benefit from evidence based health information, but the focus of this effort ought to address more meaningful goals of medicine and human welfare.

An article published in Substance Use and Misuse points out that of the over 15,000 individuals there was no significant relationship between alcohol consumption and physical activity (PA) study link. This article offers common sense health advice for future efforts: “Prevention programs to increase PA levels from low to moderate combined with a reduction of alcohol intake in men who regularly drink alcohol should be considered.” This conclusion is based on the finding that persons who drink heavily also have lower physical activity levels. Hardly seems groundbreaking. Yet, if there had been a correlation suggesting that heavy drinkers are also quite physically active, what would this offer as a useful nugget of health information? Don’t worry about heavy alcohol consumption?

Studying the long term effect of wearing high heel shoes has also gained attention in the media and academic literature. Though, in fairness, I suppose someone has to study it so we can provide evidence based practice considerations to persons who develop foot or ankle problems, or are required to wear high heels as part of a work uniform. “One condition known to compound the difficulty of walking is the use of high heeled shoes.”  study link #2.  I believe all who have worn high heels are likely to agree on this point. The piece does offer some considerations about blood flow to the lower extremities, which could be helpful to physicians treating patients with high heeled related ambulatory difficulties, so a relevant factor in advising patients. Nonetheless, it seems a bit startling that such research is surfacing in the media to answer this question for consumers.  A recent New York Times blog (blogs.nytimes.com/2015/06/17) titled “Reducing the frequency of wearing high-heeled shoes and increasing ankle strength can prevent ankle injury in women” leads off with a critique of having a character run from Jurassic dinosaurs while she is wearing high heels, and offers evidence for negative effects of long term high heeled shoe wearing. Just in case there was any doubt, the article concludes with sound advice for not wearing high heels as the footwear of choice if escaping a fast moving deadly animal.

Media is a powerful too, and so is scientific inquiry. I believe the public can digest more meaningful discussions of health related matters than those which confirm common sense.

 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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01/06/2017

CGI Turing Test

[Star Wars fans spoiler alert: The following contains potential story information from “Rogue One: A Star Wars Story”, the Star Wars Episode IV prequel] I confess that I am a Stars Wars geek in particular and a science fiction movie buff in general. Like many, I am old enough to have seen the first Star Wars movie at its 1977 release, before it was re-indexed... // Read More »

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

01/06/2017

NQF Issues National Standards for Tools to Help Patients Make Healthcare Decisions

The National Quality Forum recently issued a set of national standards for decision aids, which are key resources for improving shared decision making between providers and patients.  Decision aids--such as videos, online tools, and other resourc...

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

01/06/2017

BioethicsTV (January 2-6, 2017): Violating promises, coma v. PVS, transplant evaluation, and whether to abort

by Craig Klugman, Ph.D.

Pure Genius (Season1; Episode 10- 1/5). In this episode, Dr. Channarayapatra is working with a patient in lung failure. Due to exposure to toxins dumped in the ground beneath her neighborhood, the patient’s lung tissue is disintegrating. Bunker Hill hospital is attempting to build the world’s first implantable, artificial lung but has not had success. With her lung function decreasing, the patient may soon face one of two options: death or ECMO—a process where a machine oxygenates her blood outside of the body. The viewer is told that ECMO can only be used for a maximum of two weeks.…

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