Tag: medical futility blog

Blog Posts (367)

October 30, 2014

Advance Care Planning Tools That Educate, Engage, and Empower

In the current issue of Public Policy & Aging Report, Charlie Sabatino, American Bar Association Commission on Law and Aging, has contributed "Advance Care Planning Tools That Educate, Engage, and Empower."

Sabatino reviews a variety of pathways, tools, workbooks, and decision aids have been emerging to facilitate advance care planning and to enable documentation of one’s goals and wishes. He focuses on tools that actively engage users or at least lead users through questions that result in a work product.

The issue also includes several articles on the Campaign to End Unwanted Medical Treatment.

October 30, 2014

Minnesota Network of Hospice and Palliative Care - 2015 Conference

The Minnesota Network of Hospice and Palliative Care (MNHPC) is the state's leading hospice and palliative care network. It brings together providers, business partners, individuals and donors to increase knowledge, access services, and strengthen adv...
October 29, 2014

Jahi McMath - Prematurely Fostering Mistrust

Jahi McMath was adjudicated as legally dead in December 2013.  Her family has yet to deliver any cogent, definitive evidence that supports changing her diagnosis. Can they?  Will they? If Jahi's family can establish (with independent expert ...
October 28, 2014

More Secret DNR Orders in UK - Barbara Gibson

In the UK, clinicians may write a DNR order without consent, if they deem that to be in the patient's best interest.  But clinicians must still consult with the patient or family.  In other words, they may write a unilateral DNR order.  But they may not write a "secret" DNR order.
Yet, as I have recounted on this blog more than a dozen times, this continues to happen.   One of the most recent cases occurred in August 2014 at Ayr Hospital.

In an apology letter to the family, the said: “I wish to offer my sincere apologies again on behalf of all the staff concerned for the distressing events you have described, and wish to reassure you that lessons have been learned and that practice around DNACPR decisions are being reviewed and improved as a matter of urgency across the organization. . . .  It is evident from the review of Mrs Gibson’s medical records, and discussions with staff involved, there were failures in communicating the medical decisions around resuscitation to Mrs Gibson and yourselves.”

October 27, 2014

Must we all die with forced hand-feeding in Advanced Dementia? Will others honor our Living Will?

A nice video by Stanley Terman reviewing the Margot Bentley case now on appeal in British Columbia.
October 27, 2014

Brittany Maynard Urges Palliative Care Specialist to Stop Misrepresenting Her Case

Brittany Maynard urges palliative care specialist Ira Byock to stop misrepresenting her case prior to his debate with Compassion & Choices President Barbara Coombs Lee on the Diane Rehm Show this week
In comments that Brittany posted on the website for Rehm’s nationally-syndicated NPR show, she denied claims by Byock and other opponents of death with dignity that Compassion & Choices is using her to advance the aid-in-dying movement. Rehm read part of Brittany’s comments during her show. 

“I am Brittany Maynard and it concerns me that Dr. Ira Byock will speak on my ‘behalf’ at all again. I watched a special on PBS where this same individual spoke about my case as though he knew personal details about me, saying some things that were quite frankly not true.

“For example, he said that a gentle death would be available to me easily through hospice, unfortunately that would be after a great length of time, with lots of suffering (physical and emotional), and loss for my young body. He is right that this is not being accomplished successfully for many terminally ill Americans on a widespread basis across our country. This needs to change too, I agree with him there."

“But perhaps most disturbingly, Byock claimed that Compassion & Choices had somehow taken advantage of me through ‘exploitation’ and that I feel compelled to die now based on public expectations. I DO NOT, this is MY choice, I am not that weak. The day is my choice, I have the right to change my mind at any time, it is my right. I am very confident about this. This is a patient right that is critical to understanding Death with Dignity."

“The claim of exploitation is utterly false considering I had gone through the entire process of moving, physician approval for DWD [death with dignity], and filled my prescription before I EVER even spoke to anyone at Compassion and Choices about volunteering and decided to share my story. I support the organization because I support the cause. I believe this is a healthcare right and CHOICE that should be available to ALL terminally ill Americans."

“I made my decisions based on my wishes, clinical research, choices, discussions with physicians, and logic. I am not depressed or suicidal or on a ‘slippery slope.’ I have been in charge of this choice, gaining control of a terrifying terminal disease through the application of my own humane logic. We as a country have real issues with the way doctors are trained to speak about, educate and embrace realities of death."

“As a terminally ill patient, I find it disrespectful and disturbing when people discuss my personal health with details that are not accurate to push an agenda. My request is that physicians speak only what they directly know to be factually true and have a right to discuss. The best change for all our community, physicians and patients, will come from us pulling together and developing policies to protect the severely ill based on honesty, education, and humane treatment of suffering."

“I wish nothing but peace and healing for whom it is available, and a peaceful passing of comfortable choice for whom it is not.”

October 26, 2014

Medical Overview of Brain Death (Video)

Adam Webb at Emory provides an excellent and accessible overview of the medical and ethical issues involved in brain death in this recent webinar for the Southeast Chapter of the Society of Critical Care Medicine.
October 25, 2014

Making Decisions for Others - Surrogates & Unrepresented Patients (May 7-8, 2015)

Ethical dilemmas commonly arise in healthcare regarding patients who are unable to make their own medical decisions.  
  • Who is best positioned to speak for these patients, and what decisions should we allow them to make? 
  • What if the patient has no friends or close family members, or close relatives disagree on the best course of action? 
  • Should there be a limit on what parents can decide for minor children? 

Cases involving decisions by others are often the most difficult cases that health care providers confront.  Yet policies pertaining to such decisions are frequently problematic, and education for providers about these issues is rarely prioritized.

The UAMS Intensive Healthcare Ethics Workshop for 2015 aims to bring together an interdisciplinary group of scholars to share research and experiences about decision-making for others. The workshop is designed for only a limited number of participants in order to be highly interactive, and will include keynote speaker and small group sessions, as well as submitted papers and posters.   

Submit proposals here by January 12, 2015.  

Jessica Berg, JD, MPH
Interim Dean, Professor of Law and Biomedical Ethics, and Associate Director of the Law-Medicine Center
Case Western Reserve University

Douglas B. White, MD, MAS
UPMC Endowed Chair for Ethics in Critical Care Medicine and Director, Program on Ethics and Decision Making in Critical Illness
University of Pittsburgh Medical Center

D. Micah Hester, PhD
Chief, Division of Medical Humanities, Clinical Ethicist
University of Arkansas for Medical Sciences and Arkansas Children’s Hospital

October 24, 2014

Today Is Jahi McMath's Birthday

Today, October 24, is Jahi McMath's birthday.  She is 14 years old today.  Or is she?   It is hard to tell, because there remains uncertainty over whether she is alive or dead.
October 23, 2014

Supreme Court’s Decision in Tschumy: Told from the Front Line by the Lawyers Who Litigated the Case

The Minnesota State Bar Association is presenting:  "The Supreme Court’s Decision in Tschumy: Told from the Front Line by the Lawyers Who Litigated the Case."  

The Minnesota Supreme Court recently issued its long awaited opinion in the important case of In re: the Guardianship of Jeffers J. Tschumy.  In a divided opinion, the Court found that a professional guardian can order the removal of life-support from patients without court review, as long as there is no dispute about that decision among interested parties.  The case raised the difficult issue of what powers a guardian has over removing life support when a patient has no hope of recovery.  

Please join the Health Law Section for a discussion of the Supreme Court’s decision by the two attorneys who litigated this important matter.
  • Michael J. Biglow, Law Offices of Michael J. Biglow
  • Robert A. McLeod, Lindquist & Vennum LLP

Friday, November 21, 2014, 8:00 AM to 9:00 AM
River Room / Town and Country Club  Saint Paul
Please join us for breakfast beginning at 7:30 a.m.

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