Blog Posts (21)
November 29, 2013
(Last Saturday, Scott Adams, the creator of the brilliant comic strip “Dilbert,” wrote in his blog a raw piece about physician-assisted suicide, which has created something of a stir. If you wish to read it, it is here; but I warn you, it i...
November 22, 2013
[The New York Times] The old man lashed out the first night he spent in the nursing home. His behavior was so alarming that staff transferred him to a nearby hospital for evaluation.
There, the gentleman was put in restraints and sedated. “He stopped...
November 21, 2013
In his Nov. 15th post, Joe Gibes warned of how pay-for-performance—the coming standard for paying doctors and hospitals—creates an incentive for doctors unethically to refuse to treat the sickest patients. The week before, he rightly challenged m...
November 8, 2013
This past September 9, the journal JAMA Internal Medicine (formerly the Archives of Internal Medicine to oldsters like me) published a report (Huynh et.al.) that intensive care physicians at five academic hospitals perceived that up to 20% of the care ...
October 9, 2013
World-famous physicist, Stephen Hawking, is now advocating in favor of physician-assisted death, in the video shown here. I am both very glad that he is still alive, so many years after developing his illness, and that he is advocating for those people...
June 13, 2012
Okay, I am probably one of the last people in the United States (no, probably the world) to watch the movie “The Descendants”.…
April 3, 2012
From the Loyola University Chicago Neiswanger website:
Kevin O’Rourke, O.P., J.C.D., S.T.M., Dominican priest, canon lawyer, and health care ethicist died on Wednesday.…
June 24, 2011
Art Caplan asks this very question in his MSNBC column this week. When a wealthy recluse died at the age of 104, to whom did she leave her fortune?…
June 4, 2011
With so much ink and space within the blogosphere already used to reflect on the death of Dr. Jack Kevorkian, it only seems fitting that we share with you some of the best perspectives on the controversial, death-obsessed man who turned the end-of-life debate on its head for so much of the 1990s.…
June 7, 2010
Hat tip to Business Week for shedding some light on U.S. Supreme Court nominee Elena Kegan’s views on bioethics.
Here’s the rundown:
She’s pro-physician assisted suicide and opposed proposals to ban it in 1997 and has said the DEA lacks the power to penalize physicians who give life-ending drug to patients.…
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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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