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01/21/2015

Managing Conscientious Objections in Intensive Care Medicine

I was delighted to be a part of this ad hoc subcommittee of this American Thoracic Society Ethics and Conflict of Interest Committee that developed An Official Policy Statement: "Managing Conscientious Objections in Intensive Care Medicine."  It was just published in the American Journal of Respiratory and Critical Care Medicine 191(2): 219–227.

"Intensive care unit (ICU) clinicians sometimes have a conscientious objection (CO) to providing or disclosing information about a legal, professionally accepted, and otherwise available medical service. There is little guidance about how to manage COs in ICUs."

"The policy recommendations are based on the dual goals of protecting patients’ access to medical services and protecting the moral integrity of clinicians. Conceptually, accommodating COs should be considered a “shield” to protect individual clinicians’ moral integrity rather than as a “sword” to impose clinicians’ judgments on patients."


"The committee recommends that: 

  1. COs in ICUs be managed through institutional mechanisms
  2. Institutions accommodate COs,  provided doing so will not impede a patient’s or surrogate’s timely access to medical services or information or create excessive hardships for other clinicians or the institution
  3. A clinician’s CO to providing potentially inappropriate or futile medical services should not be considered sufficient justification to forgo the treatment against the objections of the patient or surrogate
  4. Institutions promote open moral dialogue and foster a culture that respects diverse values in the critical care setting."

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

01/21/2015

What Causes Couch Potatoes To Eat So Many Potato Chips?

Do you eat when you’re bored? So do I. Then again, I eat when I’m not bored, too. So the real question is: do we all eat more when we’re bored than, say, when we’re highly entertained? The answer, according … Continue reading

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01/21/2015

Ebola – Yes to isolation, quarantine, and travel restrictions (Part III)

By Adil E. Shamoo, Ph.D. (guest blogger)

The HIV experience can be used as a learning model to understand what processes may need to be used for this Ebola epidemic. While there are differences, there is much similarity, especially in the deadliness of the virus of both diseases in the early phase of the epidemic. Both are also transmitted through contact with body fluids, and can be transmitted through sexual contact. This aspect should not be overlooked; the sex drive is very strong and frequently sexual relationships defy logic and rationality. 75 % of all cases of Ebola in West Africa are contracted through sexual contacts.…

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This entry was posted in Featured Posts, Health Regulation & Law, Public Health. Posted by Adil Shamoo. Bookmark the permalink.

01/20/2015

The Bioethics Commission’s Meeting 20 Milestone

This February will mark an important milestone for the Presidential Commission for the Study of Bioethical Issues (Bioethics Commission); the Bioethics Commission will hold its 20th public meeting. The 2-day meeting will be held February 5-6, 2015, in Washington, D.C. Since President Obama issued the Executive Order establishing the Commission on November 24, 2009, it […]

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

01/20/2015

VSED & Complexities of Choosing an End Game for Dementia

On the front page of today's Science section of the New York Times, Paula Span has an important story, " Complexities of Choosing an End Game for Dementia."

Can you specify in advance of severe dementia, "triggering conditions" to ensure that nobody tries to keep you alive by spoon feeding or offering liquids?

Can people who develop dementia use VSED (“voluntarily stopping eating and drinking”) to end their lives by including such instructions in an advance directive?

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

01/19/2015

Involvement of ICU Families in Decisions: Fine-tuning the Partnership

Elie Azoulay and colleagues in Paris has just published "Involvement of ICU Families in Decisions: Fine-tuning the Partnership" in the Annals of Intensive Care. I have written a lot about the resolution of intractable end-of-lif...

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

01/19/2015

The Beginning of the End of Economism? One View

E.J. Dionne's latest column:http://www.chron.com/opinion/outlook/article/Dionne-What-change-sounds-like-6021317.php--takes aim at one of the central features of this blog. Dionne claims that we may be witnessing the beginning of the end of economism (w...

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This entry was posted in Health Care and tagged . Posted by Howard Brody. Bookmark the permalink.

01/19/2015

Ebola – Yes to isolation, quarantine, and travel restrictions (Part II)

By Adil E. Shamoo, Ph.D. (guest blogger)

Public health policy is derived from promoting public good to protect millions of people from pain and suffering; an effective policy ultimately should enhance health and happiness. The coercive powers of federal and state governments and to enforce public health policy are derived from police powers to provide safety and security to the public. The President has those powers from the plenary powers, unnamed in the constitution, but implied in those powers that protect the security of the nation. The Bill of Rights is the cornerstone that protects individual liberties against the tyranny of the coercive power of government.…

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This entry was posted in Featured Posts, Health Regulation & Law, Public Health. Posted by Adil Shamoo. Bookmark the permalink.

01/19/2015

Why Buying A Car Is So Unlike Buying Healthcare

<p style="line-height: 19.0400009155273px;"><span style="line-height: 19.0400009155273px;">Let’s say you are looking to buy a car. You think you might want to buy a Volvo so you go down to the Volvo dealer and check out the new models. But you are shocked by what you see. You realize that you really don’t need to spend $35 to $40,000, or more, on a new car, so you decide to visit the Subaru dealer. There you find very nice alternative models for thousands of dollars less. You are delighted to have a new Outback for about $27,000.</span></p> <p class="MsoNormal" style="line-height: 19.0400009155273px;"><span style="line-height: 19.0400009155273px;">The above story is how private markets and market choices work for the vast majority of items that we purchase to meet most of our needs as human beings. However, it has become painfully obvious that healthcare is an area where the normal model of markets and market choices do not apply. I’ll use a personal example.</span></p> <p><strong style="color: #34405b; font-family: Arial, Helvetica, sans-serif; font-size: 12px; line-height: 19.0400009155273px;">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="color: #000099; text-decoration: underline;" href="/Academic/bioethics/index.cfm">website</a>.</strong><span style="color: #34405b; font-family: Arial, Helvetica, sans-serif; font-size: 12px; line-height: 19.0400009155273px;"> </span></p>

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This entry was posted in Health Care and tagged , , , . Posted by Hayley Dittus-Doria. Bookmark the permalink.

01/17/2015

"Being Mortal" – Atul Gawande on FRONTLINE

On February 10, FRONTLINE follows renowned New Yorker writer and Boston surgeon Atul Gawande as he explores the relationships doctors have with patients who are nearing the end of life.  In conjunction with Gawande's new book, Being Mortal, ...

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