Tag: medical futility blog

Blog Posts (1206)

May 1, 2016

Health Care Costs, Futile Treatment and Patient’s Rights

Earlier this week, Professor Colleen Cartwright, did a webinar for ISQua titled "Health Care Costs, Futile Treatment and Patient’s Rights."

The presentation did not break a lot of new ground but provided a nice general overview of issues relating to end-of-life decision making.  What I especially liked was her use of "futile treatment" to encompass both treatment that is (1) unwarranted from a medical perspective and (2) unwanted from the patient's perspective.

"Futile" is typically reserved for judgments framed as clinical and physiological.  But treatment can be inappropriate not only for those reasons but also because it is unwanted by the patient.  I tried to summarize this in this graphic.







  
April 30, 2016

Dying Fast and Slow: Improving Quality of Dying and Preventing Untimely Deaths (video)

Earlier this month, a day-long conference at Saint Louis University engaged ongoing ethical and legal questions about policies and practices that hinder effective communication about dying, impact utilization and quality of services that improve dying—such as palliative care and hospice—and lead to conflict and engagement of the legal system at end of life. 

Video of all sessions of the conference (including me in session 2) are now available.

April 29, 2016

Federal Judge Orders Kaiser to "Treat" Dead Child

Clinicians at Kaiser Permanente Medical Center Roseville diagnosed Israel Stinson as dead.  But his parents dispute that diagnosis.  Yesterday, they obtained a temporary restraining order from the U.S. District Court for the Eastern Dist...
April 29, 2016

Indiana Supreme Court Allows Medical Futility Lawsuit to Proceed - Siner v. Kindred Hospital

Last August, I reported that the Court of Appeals of Indiana allowed a family to proceed with its medical malpractice action alleging that a hospital's unilateral DNR order caused the patient's death.

Today, the Indiana Supreme Court affirmed the intermediate appellate court's decision.  Kathy L. Siner v. Kindred Hospital of Indianapolis.

Geraldine Siner was 83 and suffering from advanced dementia.  In October 2007, she was admitted to Kindred Hospital for treatment of aspiration pneumonia. The family asked her to be “full code” and use whatever means necessary to save her life.

But the medical staff thought that Siner’s condition was unlikely to improve and that the family had “unrealistic expectations and strong religious beliefs.”  The ethics committee overturned the “full code” designation and changed it to “no code" - even though it recognized "legal concerns with changing code status despite family opposition."

By the time the family transferred the patient from Kindred to Methodist, she was irremediably injured from the lack of treatment at Kindred.  

No court has made a substantive ruling about the propriety of unilateral DNAR orders.  No court has made a substantive ruling about the propriety of providing less (non-CPR) treatment to a patient with a DNAR order.  The Supreme Court only decided that there is a genuine issue of material fact.  So, the family can take the case to a jury to hear and weigh the conflicting medical opinions on causation.

April 28, 2016

Cross-Cultural Perspectives on Brain Death (video)

Check out this recent presentation at Harvard comparing East and West perspectives on brain death.  
April 27, 2016

Israel Stinson - Video Purporting to Disprove Brain Death

April 27, 2016

Bioquark Questions Irreversibility of Brain Death

Bioquark claims that death may not be irreversible. The mission of the ReAnima Project is to focus on clinical research in subjects who have recently met the Uniform Determination of Death Act criteria, but who are still on cardio-pulmonary support. ...
April 26, 2016

Five Current Brain Death Cases in California

As of the end of last week, there were five brain death cases in California. 1.  Jahi McMath's federal lawsuit against the state of California seeking to revoke her death certificate. Parents of Alan Sanchez 2.  Jahi McMath's state me...
April 26, 2016

Online Summer JD Health Law Classes - HIPAA Privacy, Medical Marijuana, Compliance Institute

Starting in about one month are three wholly online summer classes for JD credit: HIPAA Privacy Medical Marijuana Law: State Regulation in the Shadow of Federal Prohibition Health Care Compliance Institute Apply here today.
April 26, 2016

Norwegian Air Force Brings ECMO to Remote Hospital

Most of the stories I read about ECMO are about how its use has expanded way beyond its intended indications.   I was pleased to see this story about how a patient in a remote northern town in Norway was able to benefit from ECMO after a fighter ...

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