Where the World Finds Bioethics Mon, 30 Nov 2015 11:00:04 +0000 en-US hourly 1 Hospital Allows Cats And Dogs to Visit Loved Ones Mon, 30 Nov 2015 11:00:00 +0000 A hospital in the city of Hamilton in Canada is allowing cats and dogs to visit loved ones when they are sick. Hospitals do not normally allow such meetings because of the risk of cross infection.

However, in recent years some hospitals authorities have become aware of the great therapeutic benefit a cat or dog can bring to a patient. Visits by specially trained therapy animals are arranged by some. 

But allowing a patient’s own pet to visit is less common and it is necessary to carefully manage the risk of cross infection. However, the benefits and pleasure this can be bring far outweigh the extra effort.  (HT: Pussington Post)

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Substantial Variation in Healthcare – Australia Too Much Like USA Sun, 29 Nov 2015 09:30:00 +0000 0 Clinician Driven Over-treatment at End of Life Sat, 28 Nov 2015 11:00:00 +0000 0 Refusing to Acknowledge the Human Dignity of Refugees Sat, 28 Nov 2015 00:04:14 +0000 Read More »]]> 0 Purple, Brown, Grey, White, and Black — Life in Death [EOL in Art 188] Fri, 27 Nov 2015 11:00:00 +0000 One last hospice photo from Daniel Schumann's  Purple, Brown, Grey, White, and Black — Life in Death.

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Body Integrity: Choice vs Design? Thu, 26 Nov 2015 18:56:19 +0000 Read More »]]> 0 Lawsuit Attacks Constitutionality of Texas Advance Directives Act Thu, 26 Nov 2015 16:34:00 +0000 0 Purple, Brown, Grey, White, and Black — Life in Death [EOL in Art 187] Thu, 26 Nov 2015 11:00:00 +0000 Another hospice photo from Daniel Schumann's  Purple, Brown, Grey, White, and Black — Life in Death.

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Are we losing the concept of objective moral truth within the church? Wed, 25 Nov 2015 14:54:25 +0000 Read More »]]> 0 Call for Abstracts BIOETHICS: PREPARING FOR THE UNKNOWN Wed, 25 Nov 2015 14:24:00 +0000 Call for Abstracts


March 17-18, 2016; Kalamazoo, Michigan


The theme of this conference, hosted by Western Michigan University’s Center for the Study of Ethics in Society, highlights uncertainty as a fundamental factor in bioethics.  Invited speakers include Insoo Hyun, associate professor of bioethics and philosophy at Case Western Reserve University, and Richard Sharp, director of the bioethics program at the Mayo Clinic.
Possible topics for submissions include unintended consequences of innovative medical technologies, public health planning for new diseases, incidental findings in clinical research and practice, prevention of medical error, and communication of risk.  Papers on this general theme will be welcomed from a variety of disciplines and perspectives in relation to policy, practice, research, and communication in fields dealing with bioethics.  These fields include, but are not limited to, bioengineering, biology, medicine, nursing, the social sciences and scientific reporting.

Submission guidelines

Submissions will be accepted in the category of formal papers and panel discussions. Submissions are welcome from academic faculty, graduate students, medical students, medical professionals and research teams consisting of any combination of these.
Submissions should be prepared for blind review; please inspect documents and remove personal information before submitting electronically in .doc/.docx or .pdf format to Corresponding authors should include names of all authors, as well as their affiliations, and the paper or panel title, on a separate title page. Completed papers or extended abstracts of 500-1,000 words will be considered for paper submissions. For panel discussions, submissions should include an abstract summarizing the overall topic of the panel, as well as separate abstracts for each author's contribution, for a total of up to 1,000 words. The deadline for submissions is December 16, 2015. Authors will be notified by January 1, 2016. Please direct inquiries to center Co-Director Sandra L. Borden.

About the center

The Western Michigan University Center for the Study of Ethics in Society encourages and supports research, teaching and service to the University and community in areas of applied and professional ethics. The conference will coincide with observance of the Ethics Center's 30th anniversary. More information about the center, and updates about the conference.

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Purple, Brown, Grey, White, and Black — Life in Death [EOL in Art 186] Wed, 25 Nov 2015 11:00:00 +0000 Photographer Daniel Schumann went to St. Francis Hospice near Dusseldorf, Germany.  He befriended several of the residents at the hospice and got their permission to photograph them throughout their stay.  The project is entitled Purple, Brown, Grey, White, and Black — Life in Death.

His photos depict the residents as they were before and after death. The effect is solemn, yet tranquil. And since death and dying lay at the heart of Schumann’s entire project, something about his subjects’ experience will always remain unknown to his viewer. 

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No Money = No ICU Treatment Wed, 25 Nov 2015 10:00:00 +0000 Gary Dowley suffered an aneurysm while riding a motorcycle on vacation in Thailand.  He needs treatment for a broken neck and leg, facial fractures and a punctured lung.  (Brisbane Times)

Lack of Insurance Coverage
Unfortunately, Dowley's travel insurance has classified his treatment as the result of a motorbike crash, and adjusted the amount of money it pays out.  The family already maxed out their credit cards to make payments. 

Hospital Refusing to Treat
The hospital would not let doctors treat Mr Dowley until they receive payment.  "They wouldn't touch him until they had money. . . .  The hospitals over here are ruthless – if you don't pay, they pull the plug."  

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Workshop review — Committed Professionals: Handling Obstacles to Ethics in Public Health Tue, 24 Nov 2015 22:08:23 +0000 0 Debate over New FDA Commissioner Tue, 24 Nov 2015 16:09:39 +0000 In a previous post, I argued in favor of Rob Califf as FDA Commissioner. Here is an article from the Duke Chronicle, exploring more of this important debate. Dr. Robert Califf, former vice chancellor of clinical and translational research, may soon be … Continue reading

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Simple Wish – Hospice Art Field Trips [EOL in Art 185] Tue, 24 Nov 2015 11:00:00 +0000 0 Jahi McMath – Demurrer to the 1st Amended Complaint – Jan. 8, 2016 Tue, 24 Nov 2015 09:30:00 +0000 0 Live Long & Prosper is the New “Good” Mon, 23 Nov 2015 21:49:48 +0000 by Craig Klugman, Ph.D.

One of my family’s Thanksgiving traditions is one common to many, that we go around the table and name something for which we are thankful. This week my list includes several things relevant to bioethics:

For most Americans though, they are often thankful for things that make them happy such as their family and their health.…

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Drifting – a Play about Accepting Death [EOL in Art 184] Mon, 23 Nov 2015 11:30:00 +0000 0 Why Defining Death Leaves Me Cold Mon, 23 Nov 2015 11:30:00 +0000 0 Drifting – a Graphic Novel about PVS [EOL in Art 183] Sun, 22 Nov 2015 12:00:00 +0000 Bill Doan's “Drifting” is being considered as more than a play. He is working with Penn State Press to do an adaptation of this as a graphic novel.

Doan's sister has suffered a traumatic brain injury and is in a permanent vegetative state.   Doan struggles with the question of what's to be done when medical technology saves a life that maybe shouldn't have been saved.  

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Who Decides When We Die? Lessons from the Life of Jahi Mcmath Sun, 22 Nov 2015 11:00:00 +0000 0 A View from the Other Side: Roboticized Care Sat, 21 Nov 2015 23:54:32 +0000 Read More »]]> 0 2016 Health Law Professors Conference Sat, 21 Nov 2015 19:33:00 +0000 0 Drifting – a Play about PVS [EOL in Art 182] Sat, 21 Nov 2015 18:52:00 +0000 Bill Doan’s play “Drifting” follows the relationship of a brother and sister, who is in a vegetative state after a traumatic brain injury. 

The play travels from the sister’s hospital room to inside the minds of each character. The play confronts the ethical challenges surrounding prolonging the sister’s life and the difficult decision the brother and the family have to make.

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How To Die Like a Victorian [EOL in Art 181] Sat, 21 Nov 2015 03:46:00 +0000 Interesting talk at the Florence Nightingale Museum.  The Victorian preoccupation with death and dying might seem morbid to modern eyes. But have we now gone too far in the opposite direction?  

In 21st century Britain, death tends to be hidden from public view. Today, medical professionals and undertakers take on many of the duties which in the past would have been carried out by the deceased’s relatives, such as washing and ‘laying out’ the body. Unlike the Victorians, today we experience a lack of familiarity with the dead which has led to the discussion of death becoming almost taboo and a subsequent rise in so called ‘death anxiety.'

In this talk, Holly Carter-Chappell will examine 19th-century memorial traditions and show how they are more relevant to modern day practices than we might think.

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A Precious Gift: Conversation Ahead of the Crisis Thu, 19 Nov 2015 19:41:00 +0000 Linda Doolin Ward and Sandra Doolin Aust
Our mother lived through the experience of our grandmother dying from complications of Alzheimer’s Disease. When she received her own Alzheimer’s diagnosis, she sat down with us and had the “talk.” She knew the course of this disease and the decisions we would face as it progressed: increasing need for assistance with daily activities, appropriate precautions to keep her safe, treatment options that she wanted to avoid including feeding tubes and ventilators that she knew from experience would not be helpful. She was very clear about what she did and did not want. Over the next eight years, we were guided by her clear and early direction, even as she lost the ability to speak in the last two years of her life. It was heartbreaking to lose her, especially in this cruel way, but she had given us a precious gift—confidence that we were doing what she would want us to do.  

Medicare on Board

We are heartened, finally, that policymakers are recognizing the value of this gift and the need to make it easier for patients, families and clinicians to have “the talk,” also known as “advance care planning.” 

In September 2014, the National Academy of Medicine (formerly the IOM) released its report, Dying in America. As the NAM website states, “no care decisions are more profound than those made near the end of life” and we have a “responsibility to ensure that end-of-life care is compassionate, affordable, sustainable, and of the best quality possible.”  

Starting in January 2016, the Centers for Medicare and Medicaid (CMS) will activate two payment codes for advance care planning services provided to Medicare beneficiaries by “qualified health professionals.” In paying for these services, CMS takes an important step in enabling seniors and other Medicare beneficiaries to make important decisions that give them control over the type of care they receive and when they receive it. 

As 2,200 people in our region turn 65 each month, the National Academy of Medicine report and Medicare’s new reimbursement policy are both important and timely. Diverse as we are, all of us will share the experience of dying. In our society, we try to push this fact of life away, and we would rather talk about almost anything else. Attention from the NAM gives us a reason to talk about it. We are honored in Kansas City that Dr. Christian Sinclair was on the NAM committee and Myra Christopher of the Center for Practical Bioethics was a reviewer.  

The Center Can Help

From our personal experience both in our respective roles at the Center for Practical Bioethics and Shepherd’s Center Central, as well as our role as daughters, we suggest that “having the conversation” ahead of the health crisis may be the most important conversation you and your family will ever have. All of us need to name someone to speak for us when we cannot speak for ourselves. Data show that 85% of us will die without the ability to make our own decisions for any number of reasons. 

The Center for Practical Bioethics has developed several tools available at, as well as a program called Caring Conversations® in the Workplace, to provide a process to help with this difficult “talk.” Anyone can download the Caring Conversations® workbook at no cost and employees from the companies and organizations who currently participate have the chance, with the help of a Center staff member, to understand the difference that initiating this talk can have in families. It requires us to be brave. And it’s worth it.  

It literally can be the difference between not having Thanksgiving together anymore because the family fought over what Mom would have wanted, and “Mom’s death brought us even closer together as a family because she made sure we all knew her wishes, and she would have been proud of how we came together to honor her.” It is never easy, but at the Center for Practical Bioethics, it’s called “the greatest peace of mind possible.”

Linda Doolin Ward is the Executive Vice President and Chief Operating Officer of the Center for Practical Bioethics, Kansas City, Mo. Sandra Doolin Aust is the Director of Coming of Age Kansas City, Shepherd’s Center of KC Central, Kansas City, Mo. Both sisters reside in Kansas City, Mo.
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Is There An Ethics Consultant In The House? Striving For Verisimilitude In Chicago Med Thu, 19 Nov 2015 16:44:23 +0000 by Kayhan Parsi, JD, PhD and Nanette Elster, JD, MPH

The new NBC medical drama Chicago Med premiered this week. A spin off of other established NBC dramas (Chicago Fire and Chicago PD), Chicago Med focuses on the working lives of health care professionals in a busy emergency department in the city of Chicago. Sound familiar? It should, because that was the premise of the hugely successful NBC series ER that premiered over 20 years ago in 1994 and launched the careers of several successful actors.…

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UK Courts Remind Clinicians – No Unilateral DNAR without Consultation Thu, 19 Nov 2015 16:10:00 +0000 Carl WinspearIn 2014, the UK Court of Appeals handed down its judgment in Tracey v. Cambridge University Hospitals NHS Foundation Trust, clarifying that clinicians must consult with the patient before writing a DNAR order.  

A study earlier this year showed that most UK clinicians had never  heard of the case.  And practice regarding DNAR orders had not changed.

This month, a new case confirmed the holding in Tracey and extended it to require consultation with the family when the patient lacks capacity.

At 3:00 am on January 3, 2011, clinicians wrote a DNAR order for incapacitated Carl Winspear without consulting his mother or family.  The physician "did not want to inflict on Carl as treatment that was distressing, painful, undignified, and futile because it had no chance of success."  When his mother learned about it, she had the DNAR order withdrawn at 12:30 pm the same day.

While Carl never coded during the 9 hours the DNAR order was in effect, the High Court held that the clinicians violated Carl's rights under the European Convention on Human Rights.  "Ms. Winspear as carer does not have a veto over the treatment plan but she is entitled to be consulted . . . ."

"I accept the claimant’s case that the core principle of prior consultation before a DNACPR decision is put into place on the case file applies in cases both of capacity and absence of capacity. The fact that there was no cardiac arrest before the notice was cancelled is not decisive, as its existence is itself an interference with private life; it is an important decision about medical treatment of a potentially life saving nature."

"If . . . it is both practicable and appropriate to consult then in the absence of some other compelling reason against consultation, the decision to file the DNACPR notice on the patient’s medical records would be procedurally flawed."

"The discharge of this procedural obligation is not a matter of challenging a clinical judgment as to the appropriate treatment for a patient. The formation of such a judgment is a necessary first step in the decision making process before a DNACPR notice is placed on file but not generally a sufficient one."

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Taking Science Seriously in the Debate on Death and Organ Transplantation Wed, 18 Nov 2015 11:00:00 +0000 Michael Nair-Collins has just published "Taking Science Seriously in the Debate on Death and Organ Transplantation" in the Nov.-Dec. Hastings Center Report.

The effort to develop international guidelines for determination of death purports to start with an objective understanding of the biology of death. So far, however, it is showing once again how moral and metaphysical claims about death often masquerade as scientific facts.

The concept of death and its relationship to organ transplantation continue to be sources of debate and confusion among academics, clinicians, and the public. Recently, an international group of scholars and clinicians, in collaboration with the World Health Organization, met in the first phase of an effort to develop international guidelines for determination of death. The goal of this first phase was to focus on the biology of death and the dying process while bracketing legal, ethical, cultural, and religious perspectives. The next phase of the project will include a broader group of stakeholders in the development of clinical practice guidelines and will use expert consensus on biomedical criteria for death from the first phase as scientific input into normative deliberation about appropriate policies and practices.

Surely, science alone cannot resolve the normative and philosophical questions intertwined in debates about moral status, legal and moral rights, the ethics of killing, and personhood and the nature of the self; however, scientific input is necessary for informed moral deliberation. An objective and unbiased investigation of the biology of death is independent of, and should be undertaken prior to, an analysis of the normative questions engendered by debate about determination of death. This strategy is explicitly endorsed by the International Guidelines for Determination of Death and reflects the prevailing view of these issues in the mainstream medical literature. 

However, this mainstream literature, exemplified by the IGDD group’s recent report, does not exhibit any of the characteristics usually associated with a scientifically rigorous investigation, such as making empirically testable and falsifiable claims, a commitment to evidence and logic over authoritative assertion, or a willingness to revise hypotheses and theories in light of new evidence. 

Indeed, the core claims and methodologies of the mainstream medical literature on death, both of which are represented by the IGDD report, are not merely scientifically unjustified; they are not science at all. This situation creates a problem for the integrity of science and the academy, and it unjustly obscures and prevents legitimate democratic and moral deliberation about issues that, at bottom, are normative, not scientific.

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Member Discussion of the Intersection of Deliberation and Education Tue, 17 Nov 2015 20:07:04 +0000 0 Member Discussion of Education Tue, 17 Nov 2015 19:39:37 +0000 0 What Should Clinicians and Bioethicists Tolerate? Tue, 17 Nov 2015 17:18:40 +0000 by J.S. Blumenthal-Barby

Last week I attended a talk by German philosopher Rainer Forst on “Toleration and Democracy”. Professor Forst, a student of Habarmas, was named “the most important political philosopher of his generation” in 2012. Forst began by noting the tension between toleration and democracy. On the one hand, democracy demands something more than mere tolerance of others and their perspectives—something more along the lines of recognition and respect. In this way, and paradoxically, every tolerance is a form of intolerance.…

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Member Discussion of Deliberation Tue, 17 Nov 2015 16:49:03 +0000 0 Implementing Innovations in Ethics Education Tue, 17 Nov 2015 15:34:05 +0000 0 Call for Abstracts “Contemporary Issues in End-of-Life Care” Tue, 17 Nov 2015 14:56:00 +0000 University of Ottawa - Desmarais BuildingCall for Abstracts for the session “Contemporary Issues in End-of-Life Care” at the Canadian Society for the Sociology of Health Fifth Biennial Conference

Conference date: May 5 – 6, 2016.

Conference location: Ottawa, Ontario, Canada.

Abstract submission deadline: December 4, 2015.

Session Description:  Contemporary end-of-life care is continually evolving since the emergence of palliative care in the 1960s. Various new actors, institutions, and discourses are entering the scene and remaking the field in unexpected ways. At the same time, scholars are paying increased attention to myriad ways in which end-of-life care is enacted, both within and outside of settings more typically associated with health care. Policy makers too are increasingly motivated to pay greater attention to end-of-life care due to the aging of the population and increased public interest. 

For this session, we solicit papers that speak to the various contemporary experiences, changes, conflicts, and successes in the practice of end-of-life care in Canada and elsewhere, in clinical/hospital or other settings. While we welcome theoretical papers, we are primarily interested in papers that build upon empirical data that can make a unique contribution to the social study of end-of-life care. 

The goal of the session is to have a productive interdisciplinary discussion on end-of-life care; as such, we welcome contributions not only from sociology but also from other social and health sciences disciplines such as nursing, education, bioethics, anthropology, geography, and others. Abstract  should include objectives, background, methods, findings and conclusions.

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Bioethics Committee Meeting 23: Live from Arlington, Virginia Tue, 17 Nov 2015 14:10:14 +0000 0 The United States of Short Hospital Stays Tue, 17 Nov 2015 13:28:49 +0000 We spend more for medical care in the United States than just about anywhere in the world, but it’s not because people in this country get admitted to the hospital and stay for long periods of time. Instead, we have … Continue reading

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Nevada Supreme Court Questions Brain Death Standards Tue, 17 Nov 2015 04:09:00 +0000 0 Medicare Coverage for Advance Care Planning Mon, 16 Nov 2015 11:00:00 +0000 0 Aid in Dying: A Terminally Ill Patient’s Right to Choose and What Practitioners Need to Know Sun, 15 Nov 2015 20:00:00 +0000 Check out this blue chip all-day program from the New York State Bar Association on December 16: "Aid in Dying: A Terminally Ill Patient’s Right to Choose and What Practitioners Need to Know."

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Effective EOL Communicaton (cartoon) Sun, 15 Nov 2015 10:30:00 +0000 0 Clinical Criteria for Physician Aid in Dying Sat, 14 Nov 2015 18:50:00 +0000 0 Minnesota Network of Hospice and Palliative Care – Fall Forum Fri, 13 Nov 2015 15:03:00 +0000 0 Do we need more paternalism in the NFL to protect players from themselves? Thu, 12 Nov 2015 17:38:31 +0000 by Keisha Ray, Ph.D.

This week the St. Louis Rams, a National Football League (NFL) team posted a picture on Twitter of player Wes Welker signing papers, making his departure from the Denver Broncos and his membership in the Rams organization official. Fans, coaches, players, sports commentators and writers typically weigh in on situations like Welker’s by commenting on how players who join new teams will impact their team and other teams in the division, or how players will change the dynamics of the entire NFL league.…

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Why HPV Vaccination Should Not Be Required for School Attendance Thu, 12 Nov 2015 14:54:00 +0000 0 Should we require HPV vaccine for school attendance? Thu, 12 Nov 2015 14:46:24 +0000 ]]> 0 Is There Ever a Role for the Unilateral DNR Order in Pediatric Care? Thu, 12 Nov 2015 09:30:00 +0000 0 Model Protocol on Accommodating Family Objections to Brain Death Thu, 12 Nov 2015 09:30:00 +0000 0 Advance Care Planning – My New Consumer Guide Wed, 11 Nov 2015 09:30:00 +0000 0 “More Welders, Less Philosophers” Wed, 11 Nov 2015 08:14:12 +0000 by Craig Klugman, Ph.D.

I couldn’t believe it when GOP Presidential Candidate Marco Rubio said that “we need more welders and less philosophers” during the November 10 GOP Presidential Candidate debates. For the moment, I’ll put the incorrect grammar aside (it should be “fewer philosophers, not less”). As someone who is employed in an area of applied philosophy, I certainly found this offensive. As a bioethicist I work to help people think more and I hope that I have a positive influence on the world.…

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