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05/25/2016

Specialty Drugs at Especially High Prices

There have been many wonderful new medications in the past decade or so, drugs that finally bring hope for many people with serious illnesses like rheumatoid arthritis, multiple sclerosis and even some advanced cancers. But these drugs often come at … Continue reading

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05/25/2016

Why do families have different expectations at the end of life than physicians?

I have a friend who is a funeral director. I am a family physician. One of the things that we have in common is that we both deal with death and dying and how families deal with the death of a loved one. The other day he was wondering out loud why families call the ambulance service when their loved one is clearly dead, and... // Read More »

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

05/25/2016

Beppino Englaro Wins Judgment for Unwanted Treatment

Three years ago, I published "Clinicians May Not Administer Life-Sustaining Treatment Without Consent: Civil, Criminal, and Disciplinary Sanctions."   My main point was that while the risk of legal penalties for administering unwanted life-susta...

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

05/24/2016

Colorado Enacts Legislative Solution for Unrepresented Patients

I was delighted to present, this weekend, with Jean Abbott and Debra Bennett-Woods at ICCEC 2016.  We discussed new legislation in Colorado that addresses medical decision for incapacitated unrepresented patients.  

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05/24/2016

HEARING THE CALL: A Feature on How Physicians and Medical Educators Came to Understand their Vocation

My Family Doctor By Janet Piskurich I grew up in a small steel town not knowing about the immune deficiency that caused me to spend more time in my family doctor’s office than most girls my age.  I still remember the mirror on his forehead, the way his mustache moved when he examined my throat […]

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05/24/2016

Israel Stinson, Still Dead, Transferred from California to Cuba

Like Jahi McMath in early 2014, Israel Stinson has been transferred from a California hospital, despite having been determined dead.



On May 23, the family withdrew as moot their emergency motion for an injunction from the U.S. Court of Appeals for the Ninth Circuit.  

That motion is moot, because on Saturday, May 21, 2016 at 5:30 a.m. "an air transport team consisting of a registered nurse and a respiratory therapist, as well as a ground transport team, prepared Israel for transport with the assistance of Kaiser’s medical team."

"At approximately 7:30 a.m., Israel was transported by ambulance to McClellan Airport in  Sacramento. From there, Israel and his parents were transported by air ambulance to a hospital where he has been admitted as a patient."

The family reports that he was transferred "out of the United States."  They further report that a neurologist and pediatric specialist at the new hospital have concluded that [Israel] is NOT brain dead." 

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

05/23/2016

Hastening Death by Voluntarily Stopping Eating and Drinking – 2 Day Conference

I am looking forward to this conference on VSED.  

As recent op-eds suggest, this is an under-discussed means of hastening death.

Seattle
                                University School of Law

Hastening Death by Voluntarily Stopping Eating and Drinking: Clinical, Legal, Ethical, Religious and Family Perspectives


Voluntarily stopping eating and drinking (VSED) is one way to assuredly hasten death. Though generally regarded as legal, VSED has not gained nearly as much public or scholarly attention as the physician-assisted dying that is legal in only five states. This interdisciplinary conference will address ethical, legal, clinical, religious, personal, family, and institutional issues posed by VSED, including contexts of hospice and dementia care.


October 14-15, 2016
11.75 General CLE credits pending; Social Work and Nursing credits application pending


Featured Speakers Include:


  • Margaret Battin, PhD, University of Utah

  • Norman Cantor, JD, Rutgers University School of Law

  • Annette E. Clark, JD, Dean, Seattle University School of Law

  • Amy Freeman, JD, WA State Long Term Care Ombudsman Program Attorney

  • Linda Ganzini, MD, MPH, Oregon Health Sciences University

  • Gerri Haynes, RN, BSN, palliative care leader, Seattle

  • Trudy James, MRE, Multi-Faith Chaplain, Seattle

  • Anson Laytner, rabbi and author, Seattle

  • Michael Jaycox, PhD, Theology & Religious Studies, Seattle University

  • Paul T. Menzel, PhD, Pacific Lutheran University

  • Thaddeus M. Pope, JD, PhD, Mitchell Hamline Law School

  • Timothy E. Quill, MD, University of Rochester School of Medicine

  • Diane Rehm, Diane Rehm Show (NPR, APR), author

  • Judith Schwarz, RN, PhD, Clinical Coordinator, EOLCNY

  • Phyllis Shacter, TEDx talk “Not Here By Choice”

  • Sarah Shannon, RN, PhD, Oregon Health Sciences University

  • Paula Span, NY Times reporter, NewOldAge blog

  • Joan M. Teno, MD, MS, Palliative Care, University of Washington

  • Stanley Terman, MD, PhD, Caring Advocates (Carlsbad, CA)

  • Robert Truog, MD, Center for Bioethics, Harvard University

Learn more about the program and pricing at: law.seattleu.edu/cle/vsed

Thank you to our sponsors:
Seattle University School of Law, Seattle Journal for Social Justice, University of Washington Philosophy Department, University of Washington Bioethics & Humanities Department, End of Life Choices New York, Harvard University Center for Bioethics, Mitchell-Hamline School of Law, and End of Life Washington

Seattle University School
                                          of Law : Educating Powerful
                                          Advocates for Justice


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05/23/2016

The Politics of Fetal Pain

Earlier this year, Utah passed a fetal pain bill that requires the use of general anesthesia on women seeking abortions at 20 weeks gestation or later.  This bill, which relies on a controversial claim that fetuses may feel pain as early as 20 weeks, has been heavily criticized as an attempt to abrogate abortion rights rather than serving a legitimate protective purpose. 

The issue of fetal pain has long been a source of contention in the scientific community, and the dispute has led to several states restricting or prohibiting abortions 20 weeks or later on the basis of potential fetal pain.  While many argue that this law is just one of many across the country aimed not at protecting health, but at restricting or eliminating abortion rights, this law, in fact, seems to be justified in its goal of minimizing the possible experience of suffering by the fetus. 

While studies have not proven that a fetus can feel pain prior to the third trimester, reasonable doubt about the possibility of fetal experience of pain exists.  As E. Christian Brugger argues in his article entitled “The Problem of Fetal Pain and Abortion: Toward an Ethical Consensus for Appropriate Behavior,” there is no moral certitude that fetuses do not feel pain after 20 weeks, and “a preponderance of evidence supports the conclusion that fetal-pain experience beginning in the second trimester of pregnancy is a real possibility.”  Brugger makes the argument, drawing from several researchers of fetal neuroanatomy that all the neural structures for both pain perception and consciousness are in place by 18-20 weeks.  Furthermore, he argues that those who deny fetal consciousness until much later in pregnancy may be relying on outdated assumptions which place the seat of consciousness in the cerebral cortex, despite growing evidence that the upper brainstem and subcortical tissues may actually play a greater role.

If it is reasonable to believe that the fetal experience of pain is possible after 20 weeks, it seems equally reasonable to consider requiring anesthetic or analgesia for such fetuses to prevent unnecessary suffering.  Despite statements from ACOG and others supporting the assertion that fetal pain is not likely before the third trimester, even the possibility that the fetus may experience significant pain and distress supports the notion that, in the face of uncertainty, we should err on the side of preventing such pain.

Opponents of such requirements argue that anesthesia can pose significant and disproportionate risks to the woman with no corresponding benefit, and that the use of anesthesia will increase the cost of abortion significantly, potentially limiting access to the procedure for many women for financial reasons.  While mandating anesthesia or analgesia is not without risks, these risks are not disproportionate if the benefit is eliminating possible pain experienced by the fetus. 

Whether or not the primary purpose of this law is to curtail abortion rights, its effect is, in fact humane; that is, it is an attempt, in light of scientific and moral uncertainty, to prevent unnecessary fetal pain if, in fact, the fetus can and does experience it.  This compassionate approach seems eminently reasonable, and should be supported.

 

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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05/23/2016

Welcome 2016 HIV and Drug Abuse Prevention Research Ethics Training Institute Fellows!

The Fordham HIV and Drug Abuse Prevention Research Ethics Training Institute is delighted to announce that the following individuals have been selected as the 2016 fellows: The Fordham HIV Prevention Research Ethics Training Institute (RETI) is a training grant sponsored by the National Institute on Drug … Continue reading

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05/23/2016

Brain Cancer Awareness Month

Watching “60 Minutes” last week reminded me of why I pursued a degree in bioethics. The segment was on Duke University’s experimental treatment of glioblastoma patients and its surprising success treating this deadly cancer. There is a cautious optimism associated with this new treatment, which was granted “breakthrough status” by the FDA earlier this month. Immediately I was thrown back to 2010 when my wife’s... // Read More »

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