Tag: end of life

Blog Posts (100)

May 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 »
May 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 »
May 12, 2016

Doctors Push the PAS Envelope

Over at his “Human Exceptionalism” blog, Wesley Smith has had a steady stream of recent posts about physician-assisted suicide (PAS), also called “physician-aid-in-dying” or “medical-aid-in-dying” (MAID).  “Hat tip” to Mr. Smith for the story that introduced me to the “MAID” acronym.  It is reported that Ontario’s College of Physicians and Surgeons think that the proposed law being considered by the Canadian federal government to allow... // Read More »
May 8, 2016

Medical errors and more medical errors

Last week the BMJ reported that annually, there are 251,000 hospital deaths due to preventable medical errors in the US. There’s some debate about the calculations that they used to arrive at that number, and about what exactly constitutes a medical error. However, rather than quibble over the fine points, let’s acknowledge that medical errors are an ethical problem that must be addressed. In this... // Read More »
May 8, 2016

Medical errors and more medical errors

Last week the BMJ reported that annually, there are 251,000 hospital deaths due to preventable medical errors in the US. There’s some debate about the calculations that they used to arrive at that number, and about what exactly constitutes a medical error. However, rather than quibble over the fine points, let’s acknowledge that medical errors are an ethical problem that must be addressed. In this... // Read More »
May 8, 2016

Medical errors and more medical errors

Last week the BMJ reported that annually, there are 251,000 hospital deaths due to preventable medical errors in the US. There’s some debate about the calculations that they used to arrive at that number, and about what exactly constitutes a medical error. However, rather than quibble over the fine points, let’s acknowledge that medical errors are an ethical problem that must be addressed. In this... // Read More »
April 25, 2016

A brief thought on rising suicide rates

A recent article in The Washington Post describes a very disturbing trend: “The U.S. suicide rate has increased sharply since the turn of the century, led by an even greater rise among middle-aged white people, particularly, women, according to federal data released Friday [April 22]” The article offers some suggestions as to why things have been so grim: last decade’s severe recession, drug addiction, social isolation,... // Read More »
April 15, 2016

Doctor-Assisted Suicide in Canada: the Next Step

The general press is reporting that the Liberal majority in Canada has drafted proposed legislation to establish the conditions under which physician-assisted suicide (PAS) would be legal.  Per the Canadian Supreme Court’s order last year that PAS is allowed in Canada, the Parliament has until June 6 to pass it, or the Court’s prior order would come into force.  This would effectively leave judgments of... // Read More »
April 8, 2016

“The Enormity of the Moral Mission of Medicine”

As I write, Paul Kalanithi’s book When Breath Becomes Air sits atop the New York Times Bestseller List. I highly recommend it. It is beautiful. This book was written by a dying man. All books are, I suppose, but this author knew with more certainty than most that his time was short. Paul Kalanithi was finishing a grueling neurosurgery residency and on the cusp of... // Read More »
April 1, 2016

Ethics & Society Newsfeed: April 1, 2016

Heroin Epidemic Is Yielding to a Deadlier Cousin: Fentanyl Cheaper and far more potent, the synthetic painkiller is becoming the drug of choice for some addicts — and is killing them more quickly. Who’s “They?” We are witnessing a great … Continue reading

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Published Articles (3)

American Journal of Bioethics: Volume 11 Issue 7 - Jul 2011

A Philosophical Obituary: Dr. Jack Kevorkian Dead at 83 Leaving End of Life Debate in the US Forever Changed

American Journal of Bioethics: Volume 11 Issue 2 - Feb 2011

Book Review of D. Micah Hester, End of Life Care and Pragmatic Decision Making

American Journal of Bioethics: Volume 7 Issue 10 - Oct 2007

"Show Me" Bioethics and Politics

News (46)

October 23, 2012 6:01 pm

Watch your Words! The Challenges of Law Around the End of Life (Oxford Uinversity Blog)

[I]n South Australia last week, a bill has been proposed to clarify the legal status of advance directives. One very small part of that bill involves a modification to an older palliative care act. The modification corrects an ambiguity in wording in the earlier act. The ambiguity is subtle. However, that choice of words has had major consequences for seriously ill children and adults in South Australia and for health practitioners. It is a salutary reminder of how hard it is to enact good laws in the area of end of life, and how easily such laws can make things worse rather than better.

September 21, 2012 8:12 pm

After Death, Helping to Prolong Life (The New Tork Times)

EDINA, Minn. — Just down the hallway, in Room 356, Curtis Kelly’s body lay covered to the chest by a white blanket, his torso rising and falling with the help of a ventilator. A neurologist at Fairview Southdale Hospital had declared him brain-dead nearly six hours earlier.  Mr. Kelly’s far-flung family — a son, three siblings, a sister-in-law, his girlfriend and the daughter of a former girlfriend — had gathered in a narrow conference room in the intensive care unit so that John P. LeMay could ask permission to recover his tissue and organs.

 

August 14, 2012 7:47 pm

End-of-Life Care for Kids Raises Ethics Issues (MedPage Today)

Healthcare providers should have rapid access to legal remedies for end-of-life disputes involving children whose parents resist withdrawal of aggressive therapy on the basis of religious beliefs, authors of a review concluded.  Over a 3-year period, 17 of 203 cases could not be resolved after lengthy discussions with parents. Subsequently, most of the cases were resolved, but five remained undecided, each because of the parents’ belief in a miracle for their children, according to an article published online in the Journal of Medical Ethics.

August 14, 2012 7:45 pm

Deeply Religious Parents Often Reluctant to Cease Medical Care (ABC News)

Arthur Caplan, the head of the division of medical ethics at NYU Langone Medical Center, recalls a case of a man who had beaten his six-month-old child to death. It was a horror the mother simply could not accept.  A deeply religious woman, she pushed the doctors to do more, telling them that God would intervene and allow her daughter to make a miraculous recovery. For several hours there was a tense standoff between caregivers and parent.

August 7, 2012 9:35 pm

At the End of Life, Talk Helps Bridge a Racial Divide (The New York Times)

Living or dying is not at issue. The question this family confronts is how the patient will die: a little sooner, with adequate morphine, surrounded by loved ones in the hospice unit, or a little later, in a never dark or quiet patch of the I.C.U., ribs broken by failed, if well-intentioned, CPR.  Add to this the following: The patient and family are black. And while race should not be relevant at this moment, research tells us otherwise.

July 27, 2012 5:57 pm

Are Doctors More Likely to Refuse CPR? (The Atlantic)

Are doctors more likely to refuse revival in the event of cardiac arrest? In the Hopkins study, 90 percent of doctors said they’d rather die by cardiac arrest than be resuscitated. Only a quarter of the public feels the same way.  Do doctors know something we don’t about the miracles of CPR? In one Japanese study of 95,000 CPR cases, just eight percent of patients survived for longer than a month after being revived.

July 26, 2012 4:25 pm

King: U.S. lifestyles to blame for high health costs (Houston Chronicle)

Another challenge for the U.S. with respect to overall health care costs is our cultural approach to end of life care. Medicare now estimates that 27 percent of its budget goes for care provided in the last year of life, and a big chunk of that is spent in the last few weeks of a person’s life. The Lien Foundation did a study on end of life care in 40 developed countries. While the U.S. ranked high on the availability and quality of end-of-life care, its cost of care was one of the highest.

July 11, 2012 6:41 pm

Legal Euthanasia Didn’t Raise Death Rate, Researchers Say (Bussinessweek)

“Countries differ greatly in demography, culture and organization of medical care,” Lo, who is also director of the medical ethics program at the University of California, San Francisco, wrote in a comment accompanying the study. More in- depth information is needed to better understand how patients and physicians reach their decisions, he said.

July 10, 2012 4:23 pm

Doctor accused of ending patients' lives prematurely (ABC Online)

There are calls for a Queensland doctor to be stripped of his right to practice medicine and investigated over allegations he prematurely ended the lives of patients under his care.  Former Queensland Medical Board investigator Jo Barber says the doctor’s actions are so dangerous he could have been charged with manslaughter or murder.  Ms Barber says there are a number of deaths linked to the doctor, who, after fronting the state’s medical board, was allowed to continue practising as long as he was not working in intensive care.

July 9, 2012 9:12 pm

Ensuring a good death: a public health priority (Oxford University Press Blog)

Protecting the health and wellbeing of the population directly or indirectly involved with death and dying is a huge public health challenge. Currently, high quality end of life care is not yet available in most parts of the world, and in those countries where it is available it is not accessible or not initiated timely for all in need, independent of their disease, age, gender, socioeconomic, or ethnic background. Largely as a result of that, a large majority receives overly aggressive treatment until death or shortly before death, has undertreated psychological and physical symptoms at the end of life, and is not able to die in a place or manner that accords with their personal preferences.

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