Tag: medical futility blog

Blog Posts (395)

November 21, 2014

Brain in a Jar - Sufficient Reason to Keep Me Alive

I share this treatment preference expressed by Atul Gawande at a recent Oregon Public Broadcasting book event. "If I'm a brain in jar and I have some sort of sensory devices hooked up to me that allow me to speak, to think, to hear, to talk and to con...
November 20, 2014

Resolving Medical Futility Disputes - Alberta follows Ontario in Chalifoux v. Alberta Health Services

This month, the Court of Queen's Bench of Alberta released an eleven-page opinion in Chalifoux v. Alberta Health Services.  This is a rather typical medical futility case resolved in a typical fashion. The Patient Ava Alayla Chalifoux-C...
November 19, 2014

Martha Perez - Texas Family Charges Organs Procured BEFORE Death

I recently summarized a few cases in which a patient was either negligently or intentionally declared dead prematurely.  

But this recent case reported by Fox News in Dallas Fort Worth indicates misunderstanding by the family rather than error by the clinicians.  

26-year-old Martha Perez dies from injuries sustained in an car wreck involving a suspected drunk driver.  Perez was a registered organ donor and doctors told the family they were prepared to harvest the organs for donations.

The family objected: “But she still has heart and lung functions,” said family member Juan Martinez.  Unfortunately, this statement indicates that the family does not understand that these cardiopulmonary functions are compatible with legal death in Texas.  They can be artificially sustained even after death is determined (on neurological criteria).   

On the other hand, the family also alleges: “They took her off the life support and she was still breathing.”  If that is true, then the determination of death must have been wrong.  A person breathing on their own (without ventilation support) cannot be dead under either cardiopulmonary or neurological criteria.

November 18, 2014

Texas Legislature to Address Marlise Munoz Dead Pregnant Situation

Yesterday, on Inside Texas Politics, Texas Representative Matt Krause said he is preparing legislation for the 2015 session that will address the situation in which a pregnant woman is on life support.   Removing life support from a pregnant woma...
November 17, 2014

Janina Kolkiewicz Wakes Up in Morgue after Pronounced Dead

On November 6, a Polish physician made a house call on 91-year-old Janina Kolkiewicz.  But after finding "no basic life functions," the physician declared her dead.  Two hours later she was taken to the morgue. The physician checke...
November 16, 2014

Oregon Death with Dignity Act - 20th Anniversary

Last week marked the 20th anniversary of the Oregon Death with Dignity Act.   Ballot initiative 16 was approved in the November 8, 1994 general election. 627,980 votes (51.3%) were cast in favor, 596,018 votes (48.7%) against.  But an i...
November 16, 2014

Top 30 Bioethics Journals on Earth

This list of English-language journals was recently compiled on Udo Schuklenk's blog.  He includes the standard qualifications. Journal of Medical Ethics                           &...
November 15, 2014

First Execution under Obamacare Death Panels?

An alarming debunking of baseless and dangerous rumors at Politifact.
November 14, 2014

Dhaka Hospital Withdraws Life Support without Consent or Consultation

Momtaz Zia was admitted to the Squares Hospital in Dhaka Bangledesh on October 19 following her second cardiac arrest. She was put on life support. Yesterday, Zia died after she was taken off life support without her family's consent, allege...
November 13, 2014

Patients and Clinicians Discuss Only 2 of 11 Goals of Care Elements

Studies showing lackluster rates of advance care planning are nothing new.  But this new study in the Canadian Medical Association Journal is particularly disturbing.  

The authors identified 11 recommended elements of goals-of-care discussions that are the most important to older adults patients in hospital with serious illness and their family members.  They found that these elements are VERY infrequently addressed by health care providers in hospital.
  1. Asked the respondent about preferences for care in event of life-threatening illness
  2. Inquired about the respondent’s values
  3. Discussed prognosis 
  4. Gave an opportunity for the respondent to express fears or concerns
  5. Asked the respondent if they had additional questions about goals of care
  6. Provided information about outcomes, risks, benefits of comfort care
  7. Asked about prior discussions or written documents
  8. Offered a time to meet to discuss goals of care
  9. Provided information about outcomes, risks, benefits of life sustaining treatments
  10. Provided information to review about advance care planning before discussions
  11. Helped access legal documents to record advance care plans

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