Blog Posts (94)
April 25, 2016
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
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
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
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 →
March 11, 2016
A recent article in the Wall Street Journal (subscription required) reports that Medicare is paying more than expected for hospice care. The apparent reason: hospice is being provided to people who are not close to death. The initial idea of hospice was to provide palliative care for people with 6 months or less to live. Leave aside, for the moment, that making such a prognosis... // Read More »
February 22, 2016
The right to die has played a critical role in the development of the doctor/patient relationship. It was families clamoring for the right to allow their loved ones to die who forced the world to recognize that physicians’ medical decisions … Continue reading →
The post How to Make People Think Robots and Corpses Have Feelings appeared first on PeterUbel.com.
January 21, 2016
I generally give 5 reasons for opposing physician-assisted suicide (PAS), which is commonly recommended by its advocates by invoking the notion of a “right to die”: it destroys the soul of medicine as the profession dedicated to healing; it deflects attention from palliative care; it rests on a very slippery slope; a right to die implies a reciprocal duty to kill; and the notion of... // Read More »
January 19, 2016
As I was doing some research on the issue of physician assisted suicide and patient requests for death, I came across a news headline titled “Euthanasia Rules Relaxed for People with Serious Dementia.” Intrigued, I followed the link to learn that the Netherlands are now allowing for aid in dying to occur when severely demented patients have a written euthanasia request. From my understanding, this... // Read More »
January 7, 2016
Being Human: Core Readings in the Humanities, edited by Leon Kass, is one book worth a spot on the shelf of anyone interested in bioethics or concerns about human dignity. A series of excerpts from things that we read—or should have read—in high school or college, it was selected by the members of President George W. Bush’s President’s Council on Bioethics in 2003. The readings... // Read More »
December 24, 2015
I am thinking of two friends from church with advanced cancer, both men about my age, 60-ish. One has a high-grade brain tumor, persistent after standard therapy and more than one experimental new treatment. He’s a fighter, looking for something new to try. He’s an ex-Marine, famously fit at baseline, willing and able to tolerate some toxicity. He also tells me that he is trusting... // 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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