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04/10/2015

Toronto Police Criminally Charge Nurse for Stopping Life Support without Consent

Deanna Leblanc
Toronto police have arrested Joanna Flynn (50), a former nurse at Georgian Bay General Hospital for allegedly cutting off a patient’s life support without authorization.  

She is charged with manslaughter and with criminal negligence causing death. The victim, Deanna Leblanc (39), died at the hospital on March 2, 2014.  

The hospital CEO observed "A criminal charge involving someone at our hospital is a highly distressing occurrence and will create a good deal of anxiety for our community." (Toronto Star)  Mark Handelman said he has never seen a Canadian health care practitioner criminally charged for ending life support.

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

04/09/2015

Ideological Struggles Old and New in America: The Inappropriate Use of Coercive State Authority

<p><span style="font-size: 11.1999998092651px; line-height: 19.0400009155273px;">The history of America from the beginning was a struggle of opposing ideological perspectives over the role of the state’s power vis-à-vis the consciences of individual citizens. The 17</span><sup style="line-height: 19.0400009155273px;">th</sup><span style="font-size: 11.1999998092651px; line-height: 19.0400009155273px;"> century Puritans in the Massachusetts Bay Colony basically transported to America the same kind of religious, state intrusion into the lives of individuals they were trying to escape in England by requiring citizens to subscribe to the official state religion. Fortunately, there were courageous individuals there at the time, like Roger Williams (1603-1683), who strongly resisted such requirements. Williams, prior to coming to America, had been educated at Cambridge and worked for Lord Chief Justice </span><a style="font-size: 11.1999998092651px; line-height: 19.0400009155273px;" href="http://en.wikipedia.org/wiki/Edward_Coke">Edward Coke</a><span style="font-size: 11.1999998092651px; line-height: 19.0400009155273px;">. (1552-1634)</span><span style="font-size: 11.1999998092651px; line-height: 19.0400009155273px;">  </span><span style="font-size: 11.1999998092651px; line-height: 19.0400009155273px;">Coke was the famous English jurist whose work provided much of the foundations of the Anglo-American legal system, and who famously “declared the king to be subject to the law, and the laws of Parliament to be void if in violation of "common right and reason”.</span><span style="font-size: 11.1999998092651px; line-height: 19.0400009155273px;">  </span><span style="font-size: 11.1999998092651px; line-height: 19.0400009155273px;">No doubt Williams’ prior education and influences from Coke, and from others like Francis Bacon (1561-1626) who taught him the way of learning through experiment and observation, helped temper his strong theological commitments in relation to his views about the proper relationship between the authority of the state and religion, and the extent to which the state could have control over the consciences of free individuals, what Williams called “soul liberty”. Williams himself did not have theological quarrels with the Puritans; however, he did not believe religious conviction could be coerced. It was on this moral and political basis, that Williams founded Rhode Island, the first state ever to have a constitution guaranteeing expansive freedom of conscience to individual citizens. Fortunately, the thinking of Williams became the mindset of the key founders, particularly Jefferson (1743-1826) and Madison (1751-1836), of the American constitutional system. (For a full account of Roger Williams’ life and influence, see the wonderful book, </span><em style="font-size: 11.1999998092651px; line-height: 19.0400009155273px;">Roger Williams and the Creation of the American Soul: Church, State, and the Birth of Liberty</em><span style="font-size: 11.1999998092651px; line-height: 19.0400009155273px;"> by John M. Barry)</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><span style="line-height: 19.0400009155273px; color: #34405b; font-family: Arial, Helvetica, sans-serif; font-size: 12px;"> </span></p>

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04/09/2015

Bioethics Commission Makes Recommendation on Equitable Access to Safe and Effective Neural Modifiers

The Presidential Commission for the Study of Bioethical Issues (Bioethics Commission) recently released Gray Matters: Topics at the Intersection of Neuroscience, Ethics, and Society. In this report the Bioethics Commission considered in depth ethical concerns raised by the development and use of novel forms of neural modification, including those designed to enhance cognition. The Bioethics […]

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

04/09/2015

Incentive to Stop Smoking?

In the United States, the FDA tried to mandate that cigarette companies put nasty images of the harms of smoking onto cigarette packages, images that would take up at least half of the carton. It looks like that effort has … Continue reading

The post Incentive to Stop Smoking? appeared first on PeterUbel.com.

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04/09/2015

Do Your Little Bit of Good: National Pain Strategy Comment Period Ends May 20

Do Your Little Bit of Good:
National Pain Strategy Comment Period Ends May 20


2.2 Create a comprehensive population health-level strategy for pain….
(Complete before the end of 2012)


In June 2011, those of us who served on the Institute of Medicine’s committee that published Relieving Pain in America sent our report to Congress. It included sixteen recommendations to improve care for at least 100 million Americans who live with chronic pain. It provided what we referred to as a blueprint to “transform the way pain is perceived, judged and treated.”

Our first recommendation (2.1) was to “improve the collection and reporting of data on pain.” We had all been dismayed to learn how little reliable data we actually had to draw from in our process. The second recommendation (2.2) was to “create a comprehensive population health-level strategy for pain prevention, treatment, management, and research. Our “blueprint” was fundamentally a timeline which sequenced our recommendations. We ranked the population health-strategy as our first priority and asked that it be completed within 18 months, i.e., by the end of 2012.

It has been my privilege to serve on the National Pain Strategy Oversight Committee, which was charged by the Department of Health and Human Services (HHS) with developing the plan called for by the IOM. Unfortunately, that charge was not issued until the end of 2012 and the process took much longer than we had anticipated. The committee’s work was completed last summer and then it entered the vetting process. The good news, however, is that last week the National Pain Strategy Report was posted in the Federal Register. Until May 20, 2015, recommendations and comments from the public are possible.

We wish to strongly encourage all of those interested in efforts to improve chronic pain care to review this document and share your thoughts about it. You can do so by going to -
https://www.federalregister.gov/articles/2015/04/02/2015-07626/draft-national-pain-strategy

The report is only 43 pages and is organized in six sections: 1) Population Research, 
2) Prevention and Care, 3) Disparities, 4) Service Delivery and Reimbursement, 5) Professional Education and Training, 6) Public Education and Communication.

Each section contains a statement of “the problem” and then provides objectives and strategies for remedying that problem. From my perspective, some of the Report’s most important objectives are to:
• Foster the collection of more and better data for all populations, including developing metrics for measuring progress. (Good solutions always start with good facts.)
• Determine and analyze the benefit and cost of current prevention and treatment approaches and create incentives for using those treatments with high benefit-to-cost ratios. (Get the biggest bang for the buck.)
• Develop standardized and comprehensive pain assessments and outcome measures intended to increase functionality. (Move beyond 1-10 pain scales.)
• Acknowledge and address biases in pain care. (Biases that are implicit, conscious or unconscious.)
• Demonstrate the benefit of inter-disciplinary, multi-modal care, including behavioral health, for chronic pain. (Pain is a complex issue that requires complex solutions.)
• Align reimbursement with care models that produce optimal patient outcomes. (Both public and private payers are critical to reform.)

Perhaps, most important of all, however, is to improve health literacy, communication and education about pain among patients, healthcare providers, policy makers and the public. 

More than 80 pain and policy experts from across the country volunteered their time to develop this report. Many others in federal agencies have also been involved, and all agreed to the following vision:
If the objectives of the National Pain Strategy are achieved,
the nation would see a decrease in the prevalence across the
continuum of pain, from acute, to chronic, to high-impact
chronic pain, and across the life span from pediatric through
geriatric populations, to end of life, which would reduce the
burden of pain for individuals, families and society as a whole.
Americans experiencing pain – across the broad continuum —
would have timely access to  a care system that meets their
bio-psychosocial needs and takes into account  individual
preferences, risks, and social contexts.  In other words they
would receive patient-centered care.


Further Americans in general would recognize chronic pain  
as a complex disease and a threat to public health and a just
and productive society. 


All those involved in developing the report are committed to getting it right, and to do so, it is critical that people living with chronic pain, their families and those who care for them (especially primary care providers) provide input and feedback. To paraphrase Bishop Desmond Tutu, “Do your little bit of good…. It is those things put together that change the world.”


https://www.federalregister.gov/articles/2015/04/02/2015-07626/draft-national-pain-strategy


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

04/09/2015

Lawsuit for Unilateral Withdrawal – King v. Summa Health

A few days ago, the family of Minnie King filed a lawsuit against Summa Health System in Akron, Ohio.  They allege that clinicians at Akron City Hospital "withdrew life-sustaining treatment . . . without consent."  The claims are for (1) wro...

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

04/08/2015

Is a gift of ribs “slightly unethical” in the physician-patient relationship?

by Craig Klugman, Ph.D.

In an editorial in the Chicago Tribune, a physician tells the story of an underserved patient who owned a rib joint. The patient would bring ribs whenever he had an appointment. And once a year, the patient would come to the hospital just to bring a smoked Thanksgiving turkey to the physician.

The patient lacks insurance and thus is not able to get a badly needed hip replacement. As the story continues, the physician contacts an orthopedic surgeon in another health system in hopes of getting treatment for the rib-producing patient. After 4 years, a spot for a pro bono surgery opens and the “orthopedic colleague” sees the patient, who is now in intense pain and desperate need of a new hip.…

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This entry was posted in Conflict of Interest, Featured Posts and tagged , . Posted by Craig Klugman. Bookmark the permalink.

04/08/2015

Texas Futility Law – House Committee Hearing Today

Rep. Harless I recently recapped the several bills introduced that were this session to amend the dispute resolution provisions in the Texas Advance Directives Act.   This morning at 10:30, the House State Affairs Committee will hold a he...

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

04/08/2015

Would Better Risk Communication Reduce Fear of Flying?

With so much recent news about airplane disasters, it’s easy to become frightened about flying. I wonder if a risk graphic like the following will do much to help? As reported on recently in The Economist, the risk graphic comes … Continue reading

The post Would Better Risk Communication Reduce Fear of Flying? 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.

04/08/2015

Religious freedom revisited

When I reflect on what has happened in Indiana since I wrote my post of last week I think that Mark McQuain was right in his comment that I was being overly optimistic in my statement “I hope that people will be able to see that upholding the fundamental principle of religious freedom is something that still should be important in our nation.” Since I... // Read More »

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