Blog Posts (124)
February 19, 2017
Oregon Senate Bill 494 has been described as a “euthanasia bill” that is “intentionally ambiguous,” and as a piece of legislation that would “allow the starving and dehydrating of patients who suffer from dementia or mental illness.” What has received less press is the composition of the 13-member committee who would be perpetually in charge of advance directive forms in the state, with no oversight by... // Read More »
February 18, 2017
The default mode of our technologically advanced medicine is to use our technology. Nowhere is this more true than close to the end of life. And our technology is really impressive; with it, we can keep chests going up and down and hearts beating for a long, long time. The troubling thing is that there are many people who would rather not have lots of... // Read More »
February 7, 2017
In the blog yesterday, Neil Skjoldal reminded us that bioethics will likely again play a role in the upcoming nomination process of Judge Neil Gorsuch to be an Associate Justice on the Supreme Court of the United States (SCOTUS). Why is this the case? To paraphrase Professor H. Tristram Engelhardt, I believe it is due in part to the inability of moral strangers to resolve... // Read More »
February 6, 2017
Some of us had hoped that bioethics would have been an issue in the presidential election of 2016, but that was not to be. Now, less than three weeks into the Trump presidency, bioethics appears to have resurfaced in the nomination of Judge Neil Gorsuch to be an associate justice on the Supreme Court. Amidst all the media coverage of his appointment, The Washington Post, among... // Read More »
January 29, 2017
Though a relative “latecomer” in the legalization of physician-assisted suicide (PAS), Canada seems determined to make up for lost time. Already the question of organ donation after PAS has been raised. Very recently, the medical “savings” made possible by the legalization of PAS in 2016 was brought to light. The January 23, 2017 volume of the Canadian Medical Association Journal (CMAJ) published the results of... // Read More »
January 27, 2017
An article in the Journal of Medical Ethics (JME) assesses the ethical issues around organ donation by someone who requests assisted suicide or (“voluntary”) euthanasia. (Subscription or purchase is required for access to the full article.) The authors, specifically looking at the situation under current law in Canada, refer to assisted suicide and euthanasia with the blanket term “medical assistance in dying,” or “MAID” for... // Read More »
January 17, 2017
The decision not to receive further medical care in the face of a terminal disease is one that is generally honored if made by a fully informed, competent adult in the absence of outside coercion. Decisions to discontinue life-assisting devices already in place with that terminal disease, such as ventilators, feeding tubes and cardiac pacemakers, begin to complicate the decision as the process moves beyond... // Read More »
January 5, 2017
I recently received email notification of the 2016 update of the “Medscape Ethics Report: Life, Death, and Pain.” Follow the link to view a slide set summarizing the results from 7505 surveyed physicians, 63% of whom were female: Physician-assisted suicide (PAS) for “terminally ill patients”: DOCTORS now favor it, 57%-29%, up from 46%-41% in 2010. The proportion saying “it depends” remains at 14%. What’s driving... // Read More »
January 4, 2017
I just finished reading Richard Weikart’s new book, The Death of Humanity: And the Case for Life. Weikart is a professor of history at California State University, Stanislaus and has presented several papers at CBHD summer conferences. His latest book looks at how western culture has lost an understanding of the concept of human dignity and the value of human life. He details the historical... // Read More »
December 4, 2016
By many indications, support for the legalization of physician-assisted suicide [PAS] is increasing. On November 8, 2016 Colorado voters passed Proposition 106, “Colorado End of Life Options Act,” by a 65% to 35% margin, making Colorado the sixth state to legalize PAS, joining Oregon, Washington, Montana, Vermont, and California. The following question appeared in a 2015 Gallup poll: “When a person has a disease that... // Read More »
View More Blog Entries
October 23, 2012 6:01 pm
[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
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
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
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
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 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
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
“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
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
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.
View More News Items