Blog Posts (107)
September 16, 2016
Early this past June, the Annual Meeting of the American Society of Clinical Oncology (ASCO) included an ethics session featuring a point-counterpoint discussion, with audience Q+A, of “physician aid in dying,” or, as I think more accurate, “physician-assisted suicide (PAS).” Discussants were Dr. Timothy Quill, a palliative care specialist who is a past plaintiff in court cases seeking legal approval of PAS, and Dr. Daniel... // Read More »
September 7, 2016
Thanks go to Jon Holmlund for making us aware of the “Consensus Statement on Conscientious Objection in Healthcare” written by Julian Savulescu and a like-minded group of philosophers and ethicists. The statement, which represents one extreme in the discussion of rights of conscience and not a consensus of all those involved in this issue, seeks to transform negative rights into positive rights. That is, they... // Read More »
September 2, 2016
In June of this year, a group of ethicists—should I say that I use that term loosely?—issued a “consensus statement” to guide legislation and institutional policy regarding conscientious objection in medicine. Conscientious objection, they explained, “is the refusal to provide a certain medical service, for example an abortion or medical assistance in dying, because it conflicts with the practitioner’s moral views.” Their words, not mine.... // Read More »
August 17, 2016
The article “I’m a Christian with Stage IV Cancer. I Want Death with Dignity.” by Corinne Johns-Treat on time.com that Neil Skjoldal discussed in his post on Monday illustrates a problem within the church that I have become very concerned about. I have written about this concern before in the context of what I hear from students at the Christian university where I teach, but... // Read More »
August 13, 2016
In the Netherlands, a doctor will not be prosecuted for assisting a patient to die either through euthanasia or assisted suicide (EAS) if certain conditions are met, among which are the following: The patient’s request for aid-in-dying must be voluntary and well-informed, without coercion from others, and uninfluenced by psychological illness or drugs; their suffering should be unbearable and hopeless, with no prospect for improvement... // Read More »
August 1, 2016
A recent JAMA article (subscription needed) shares the findings of a study which considers the “Attitudes and Practices of Euthanasia and Physician-Assisted Suicide in the United States, Canada, and Europe.” As California has become the most recent state to add an “assisted death” law to the books, it is important to consider how the practices of euthanasia and physician-assisted suicide are viewed in places that... // Read More »
July 28, 2016
The Wall Street Journal op-ed page this week carried an offering (subscription required) from one Dr. Philip Driesbach, a cancer doctor in California who is one of six plaintiffs on a lawsuit attempting to block California’s new “End of Life Options Act,” which went into effect July 9. Dr. Driesbach’s article covers several key points: · By allowing such individuals as potential heirs and the... // Read More »
May 25, 2016
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
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
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 »
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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.
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