Where the World Finds Bioethics Fri, 24 Oct 2014 16:36:09 +0000 en-US hourly 1 Today Is Jahi McMath’s Birthday Fri, 24 Oct 2014 07:30:00 +0000 0 Ebola Fever: “Don’t Panic” Fri, 24 Oct 2014 05:11:44 +0000 by Craig Klugman, Ph.D.

In The Hitchhiker’s Guide to the Galaxy, author Douglas Adams provided his protagonist with two pieces of advise: don’t panic and always carry a towel. The first is good advice when it comes to Ebola panic.

I was sitting down on the plane in San Diego airport after the American Society for Bioethics & Humanities meeting when I noticed a woman walking down the aisle with a face mask. Being a public health-oriented person, I figured she had tuberculosis and was under order to wear a mask to protect other people’s health.…

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The “Brains” Behind the Bioethics Commission and Why a Multidisciplinary Approach is the Smartest Approach Thu, 23 Oct 2014 16:06:34 +0000 0 Fear and Loathing in Liberia Thu, 23 Oct 2014 12:31:43 +0000 ]]> 0 Hope vs Realism in Cancer Research Thu, 23 Oct 2014 12:22:10 +0000 Read More »]]> 0 Supreme Court’s Decision in Tschumy: Told from the Front Line by the Lawyers Who Litigated the Case Thu, 23 Oct 2014 08:30:00 +0000 The Minnesota State Bar Association is presenting:  "The Supreme Court’s Decision in Tschumy: Told from the Front Line by the Lawyers Who Litigated the Case."  

The Minnesota Supreme Court recently issued its long awaited opinion in the important case of In re: the Guardianship of Jeffers J. Tschumy.  In a divided opinion, the Court found that a professional guardian can order the removal of life-support from patients without court review, as long as there is no dispute about that decision among interested parties.  The case raised the difficult issue of what powers a guardian has over removing life support when a patient has no hope of recovery.  

Please join the Health Law Section for a discussion of the Supreme Court’s decision by the two attorneys who litigated this important matter.
  • Michael J. Biglow, Law Offices of Michael J. Biglow
  • Robert A. McLeod, Lindquist & Vennum LLP

Friday, November 21, 2014, 8:00 AM to 9:00 AM
River Room / Town and Country Club  Saint Paul
Please join us for breakfast beginning at 7:30 a.m.

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The Ethics of Sperm Freezing for Teenage Boys Thu, 23 Oct 2014 03:10:12 +0000 0 What I learned from my first ASBH meeting Thu, 23 Oct 2014 00:15:04 +0000 by Keisha Ray, Ph.D.

This past weekend, for the first time I attended the annual meeting of the American Society for Bioethics and Humanities (ASBH). I went with a lot of expectations and a lot of anxiety. I am a junior scholar and I am on the job market this year. I know the importance of connections and networking so I went to the meeting knowing that I needed to introduce myself to people on hiring committees, professors, and practitioners. But the thought of approaching people that I did not know and introducing myself was not met with warm, happy feelings.…

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VA Hospital Mistakenly Places DNR Order on Roland Mayo Wed, 22 Oct 2014 07:30:00 +0000 0 Barbara Mancini: Innocent of Assisted Suicide Tue, 21 Oct 2014 18:21:00 +0000 0 North Dakota Personhood Amendment – Impact on End-of-Life Care Tue, 21 Oct 2014 08:00:00 +0000 0 Multidisciplinary Learning for Medical Students Tue, 21 Oct 2014 03:10:07 +0000 0 Jean Davies – Successful VSED Mon, 20 Oct 2014 07:00:00 +0000 0 Death From Ebola: What do we do with the deceased? Mon, 20 Oct 2014 05:36:38 +0000 by Craig Klugman, Ph.D.

In the United States in the year 1900, 52.6% of all deaths were due to infectious disease. the number one cause of death. When these patients died, a family member, friend, or member of a burial society washed their bodies and cleaned them. Their families held wakes and funerals in their homes, often laying out the body in the parlor. They would all go to the cemetery and the body would be buried in a family grave.…

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VSED Interview – Not Here by Choice with Phyllis Shacter Sun, 19 Oct 2014 07:30:00 +0000 0 "Brain Death" : Facilitating Family/Hospital Dialogue about Death by Neurological Criteria Sun, 19 Oct 2014 02:20:00 +0000 0 Jahi McMath Family Gathering Better Evidence Refuting Death Diagnosis Sat, 18 Oct 2014 22:28:00 +0000 0 What If You Had To Keep PAYING Life Support Machine To Stay Alive? Sat, 18 Oct 2014 13:22:00 +0000 0 Where Have All the Heroes Gone…? Sat, 18 Oct 2014 13:21:11 +0000 Read More »]]> 0 Barbara Mancini Assisted Suicide Case Sat, 18 Oct 2014 07:30:00 +0000 0 Metaphor: Shopping Sat, 18 Oct 2014 02:38:46 +0000 Read More »]]> 0 Death by Neurologic Criteria 1968 – 2014: Changing Interpretations Fri, 17 Oct 2014 09:00:00 +0000 0 Ebola and the Challenge of Public Conversations Fri, 17 Oct 2014 03:26:28 +0000 Read More »]]> 0 The Best-Selling Biologic Drugs Thu, 16 Oct 2014 19:18:45 +0000 Continue reading ]]> 0 The Great Ebola Race: An appeal to honor the common good Thu, 16 Oct 2014 09:56:04 +0000 by Craig Klugman, Ph.D.

In the time of the black plague, people with symptoms were often placed into separate areas. The sick and symptomatic were separated from the general populace.

When ships came into harbors they were often kept there for weeks until it was assured that they did not carry disease with them.

Cities would close their gates to travels to prevent anyone from arriving who might bring disease as well as to protect travelers from disease when it raged within.…

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Minnesota Sentences Melchert-Dinkel to 178 Days in Jail for Assisted Suicide Thu, 16 Oct 2014 08:00:00 +0000 Even in the five states (MT, NM, OR, VT, WA) where aid in dying is legal, assisted suicide is not.  

Aid in dying is for capacitated, terminally ill patients like Brittany Maynard.  In contrast, assisted suicide occurs under less controlled and less justifiable circumstances.  

Case in point:  William Melchert-Dinkel, who was just re-sentenced in Minnesota for preying upon suicidal people — encouraging two to take their lives.

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Dying in America: IOM Recommendations and Next Steps for Stakeholders Thu, 16 Oct 2014 06:07:00 +0000 On September 17, 2014, the Institute of Medicine released the report Dying in America: Improving Quality and Honoring Individual Preferences Near the End of Life, in which an expert committee identified “persistent major gaps in care near the end of life that require urgent attention from numerous stakeholder groups.” The committee made comprehensive recommendations in the areas of care delivery, clinician–patient communication and advance care planning, professional education and development, payment systems and policies, and public engagement and education.

On November 10, 2014 (1:00 ET), the IOM will present a webinar that will review the recommendations, explore possible next steps and barriers to implementation, and provide an opportunity for stakeholder groups to join the conversation. (Register here)  The webinar will feature brief presentations and an extended Q&A session with: 

  • Philip Pizzo (committee co-chair), Stanford University School of Medicine
  • David M. Walker (committee co-chair), Former U.S Comptroller General
  • Christian Sinclair (committee member), Gentiva Health Services (through September 2014)
  • Adrienne Stith Butler (study director), Institute of Medicine

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Bioethics Commission to Offer Presentations at ASBH This Week Wed, 15 Oct 2014 19:16:14 +0000 0 Family Update on Jahi McMath Wed, 15 Oct 2014 11:20:00 +0000 0 Contain AND Extinguish Wed, 15 Oct 2014 01:22:59 +0000 Read More »]]> 0 Why we ignored Ebola until recently Wed, 15 Oct 2014 00:52:30 +0000 by Craig Klugman, Ph.D.

Ebola burst onto the scene in 1976 when a thirty-old man arrived at the Yambuku Mission Hospital in Zaire complaining of severe diarrhea. He left the hospital two days afterwards and was never found again. In the days and weeks that followed, people who were patients or care providers at this facility when he was there all died after experiencing dehydration, fever, vomiting, diarrhea, and bleeding everywhere. The death rate was staggering, as over 80% of affected patients did not recover.…

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Cognitive (neuro)science and bioethics Tue, 14 Oct 2014 20:23:46 +0000 by J.S. Blumenthal-Barby, Ph.D.

In a recent article in Ethics, “Beyond Point-and-Shoot Morality: Why Cognitive (Neuro)Science Matters for Ethics,” Josh Greene argues that empirical research in moral judgment has significant relevance for normative ethics in that it (1) exposes the inner workings of our moral judgments, revealing that we should have less confidence in some of our judgments and the ethical theories that are based on them, and (2) informs us of where we tend to rely on intuition or automatic processing (which is often heavily emotive), but ought to rely more manual, controlled processing (such as consequentialist reasoning).…

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Supreme Court of Canada Hears Arguments on Aid in Dying Tue, 14 Oct 2014 08:30:00 +0000 0 New Jersey Urges Medicare Coverage for Advance Care Planning Tue, 14 Oct 2014 03:53:00 +0000 A New Jersey Senate Concurrent Resolution urges CMS to provide reimbursement to physicians for advance care planning consultations with Medicare participants.  A related bill (S.2435) would provide Medicaid coverage.  Here is the text of the resolution:

WHEREAS, Advance care planning is the practice of making explicit written instructions to caregivers, family and friends on measures for delivering health care and for preserving that adult’s dignity in the event that the adult is unable, because of incapacity, to make those instructions known when needed at a later time; and

WHEREAS, Advance care planning provides support for patients and their families making difficult life decisions; and

WHEREAS, Advance care planning ensures that the patient’s informed end-of-life health care choices are known, documented, and respected; and

WHEREAS, Advance care planning provides competent adults with a legal tool to designate a health care agent and express preferences about health care options to go into effect only after the adult loses the ability to make or communicate health care decisions, including deeply personal decisions about end-of-life care; and

WHEREAS, Advance care planning includes the use of advance health care directives, health care powers of attorney, and medical orders for life-sustaining treatment that can be administered effectively within the health care system; and 

WHEREAS, Studies funded by the Agency for Healthcare Research and Quality have shown that individuals who talked with their families or physicians about their preferences for care had less fear and anxiety, felt that they had more ability to influence and direct their medical care, believed that their physicians had a better understanding of their wishes, and indicated a greater understanding and comfort level than they had before the discussion; and 

WHEREAS, New Jersey has helped promote and facilitate advanced care planning in this State with the enactment of the “New Jersey Advance Directives for Health Care Act,” P.L.1991, c.201 (C.26:2H-53 et seq.) and the “Physician Orders for Life-Sustaining Treatment Act,” P.L.2011, c.145 (C.26:2H-129 et seq.); and 

WHEREAS, An increasing number of private health insurance plans reimburse physicians for advance care planning discussions held with patients, but the federal Medicare program and most state Medicaid programs do not; and 

WHEREAS, The Specialty Society Relative Value Scale Update Committee, a body of the American Medical Association that advises the federal Centers for Medicare & Medicaid Services on Medicare physician reimbursement, has recently recommended that Medicare begin to cover advance care planning discussions; now, therefore,

BE IT RESOLVED by the Senate of the State of New Jersey (the General Assembly concurring):  This Legislature respectfully urges the Centers for Medicare & Medicaid Services to provide reimbursement to physicians for advance care planning consultations with Medicare participants.

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The Indignity of a Death with Dignity Tue, 14 Oct 2014 03:03:14 +0000 Read More »]]> 0 Barbara Mancini: Innocent of Assisted Suicide – November 13 in Saint Paul Mon, 13 Oct 2014 19:48:00 +0000 0 October 13th:  Bioethics, Women and Pain Disparity Mon, 13 Oct 2014 16:22:00 +0000

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Let Harrison Bergeron Dance Mon, 13 Oct 2014 13:51:07 +0000 ]]> 0 Tim Quill on "Near-Futile" Treatment Mon, 13 Oct 2014 08:00:00 +0000 0 Belief In Ultimate Truth: Does it make for peaceful living? Mon, 13 Oct 2014 04:10:31 +0000 0 The Price of Drugs Sun, 12 Oct 2014 15:06:51 +0000 Read More »]]> 0 Texas Medical Association Defends Advance Directives Act Sun, 12 Oct 2014 07:30:00 +0000 Konni Burton is running for the Texas State Senate as a Tea Party candidate.  She recently took a position on the end-of-life medical disputes.

Burton sent a campaign mailer that stated: “As State Senator, Konni will fight to protect the elderly and disabled patients from doctors who want to administer life-ending procedures.”  (Star Telegram)  This is an attack on Texas Health & Safety Code 166.046, the so-called Texas "medical futility law."

A letter from the Texas Medical Association Political Action Committee attacks Burton for her opposition to the 1999 law.  
  • "Do you know one single doctor who proposes to do such a thing? In my house, we would call that murder."
  •  "By this statement alone, Burton proves she is totally out of touch with the reality of medical care."
  • "Burton has demonstrated repeatedly that she is an enemy of the physicians of Texas."

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Lucas Moore: 23-week 520-gram Baby Survives Sat, 11 Oct 2014 08:30:00 +0000 Lucas Moore was born prematurely at 23 weeks weighing 520 grams, just 0.7 of an ounce over the hospital’s 500 gram cut-off point for intervention. (Telegraph)

With severe health problems – including a bleed on the brain and a hole in his heart – Lucas’s chances seemed dire, and doctors warned there was a high chance of him suffering disabilities as a result.  

But Lucas defied predictions and has now celebrated his first birthday.  The Daily Mail suggests that the case will fuel the debate over guidelines governing whether hospitals try to save the lives of extremely premature babies.

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Responding to Ebola: Questions about Resuscitation Fri, 10 Oct 2014 14:54:00 +0000 Joseph J. Fins]]> 0 Racial Disparities in Outcomes after Heart Attack Were Eliminated by Free Prescriptions Fri, 10 Oct 2014 13:22:21 +0000 Continue reading ]]> 0 Yes, Obamacare is a Success Fri, 10 Oct 2014 10:10:55 +0000 0 The Law and Ethics of Dementia Fri, 10 Oct 2014 08:30:00 +0000 Just published:  The Law and Ethics of Dementia, edited by: Charles Foster, Jonathan Herring, Israel Doron

Dementia is a topic of enormous human, medical, economic, legal and ethical importance. Its importance grows as more of us live
longer. The legal and ethical problems it raises are complex, intertwined and under-discussed. This book brings together contributions from clinicians, lawyers and ethicists - all of them world leaders in the field of dementia - and is a comprehensive, scholarly yet accessible library of all the main (and many of the fringe) perspectives. 

It begins with the medical facts: what is dementia? Who gets it? What are the current and future therapeutic and palliative options? What are the main challenges for medical and nursing care? The story is then taken up by the ethicists, who grapple with questions such as: is it legitimate to lie to dementia patients if that is a kind thing to do? Who is the person whose memory, preferences and personality have all been transformed by their disease? Should any constraints be placed on the sexual activity of patients? Are GPS tracking devices an unpardonable interference with the patient's freedom? These issues, and many more, are then examined through legal lenses. The book closes with accounts from dementia sufferers and their carers. It is the first and only book of its kind, and the authoritative text.

The book is divided into five main sections:
  1. Medical Fundamentals
  2. Ethical Perspectives
  3. Legal Perspectives
  4. Social Aspects
  5. Patient & Carer Perspectives

Twelve of the 44 chapters are in the legal section:
23. A Legal Overview Mary Donnelly
24. Assessing Capacity Lesley King and Hugh Series
25. Best Interests and Dementia Jonathan Herring
26. Proxy Decision-Making: A Legal Perspective Winsor C Schmidt
27. Being and Being Lost: Personal Identity and Dementia Jesse Wall
28. Dementia, Autonomy and Guardianship for the Old Margaret Isabel Hall
29. Restriction of Liberty Michael Schindler and Yael Waksman
30. Research on Patients with Dementia Phil Bielby
31. Dementia and Carers: Relationality and Informal Carers’ Experiences Rosie Harding
32. End-of-Life Care Ofra G Golan
33. Health Care Resource Allocation Issues in Dementia Keith Syrett
34. The Use of New Technologies in the Managementof Dementia Patients Karen Eltis

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George Watson – End-of-Life Pathway without Consultation Fri, 10 Oct 2014 06:00:00 +0000 0 Lawsuit Against U.N. on the Spread of Cholera Epidemic in Haiti Advances Thu, 09 Oct 2014 22:30:41 +0000 0 “I, Transhumanist” Thu, 09 Oct 2014 21:10:42 +0000 Read More »]]> 0