Tag: medical futility blog

Blog Posts (1421)

October 25, 2016

Sydney Festival of Death and Dying

In contemporary Western culture death and dying are generally regarded as
something to fight against, deny, hide from public view and above all fear. 

But what if we were to look at them differently? Despite understandable fear and denial, we may have very good reasons to want to learn more about death and dying. Thinking about and experiencing mortality–our own and that of others–can make us our lives richer, deeper and more valuable to us. Mortality in truth is the intensification of life.

Stretching over three days, from 18-20 November 2016, the Festival of Death and Dying includes over 30 workshops, performances, ceremonies and talks on different aspects of death and dying. In addition to talks and discussions, you will have experiences, which do justice to the full spectrum of what is at stake in mortality. 

October 24, 2016

Jahi McMath - Happy Birthday 16

Jahi McMath turns 16 years old today. She was declared dead in December 2013.  She was 13 years old at the time.  Since then, her organs have been artificially sustained in a private New Jersey home. In ongoing separate state and federal la...
October 24, 2016

Jahi McMath - Happy Birthday 16

Jahi McMath turns 16 years old today. She was declared dead in December 2013.  She was 13 years old at the time.  Since then, her organs have been artificially sustained in a private New Jersey home. In ongoing separate state and federal la...
October 23, 2016

Ontario CCB Directs Surrogate to Consent to Comfort Measures Only

In the latest of dozens of Ontario Consent and Capacity Board decisions (In re PN), the CCB directed a patient's surrogate to consent to the physician's proposed treatment in the event of a deterioration ("no CPR, no defribrillation, no mechanical vent...
October 22, 2016

Ontario Appeals Board Affirms "Written Caution" to Physicians for Writing DNR Order without Consent

This month, the Ontario Health Professions Appeal and Review (HPARB) issued a third decision in the unilateral DNR case involving Douglas DeGuerre and his substitute decision maker Elizabeth Wawrzyniak.  Earlier HPARB decisions were rele...
October 21, 2016

The VSED Exit: A Way to Speed Up Dying, Without Asking Permission

On the heels of our successful >200 participant, two-day conference last weekend, the conversation on VSED is now massively expanded with this excellent New York Times coverage:  "The VSED Exit: A Way to Speed Up Dying, Without Asking Permissio...
October 19, 2016

The Oxford Handbook of Ethics at the End of Life

I just received my hard copy of The Oxford Handbook of Ethics at the End of Life.  I am delighted to be a part (see chapter five on futility) of this fantastic anthology.  Here is the complete table of contents.

Stuart J. Youngner and Robert M. Arnold

Legal Issues in Death and Dying: How Rights and Autonomy Have Shaped Clinical Practice
Alan Meisel

“So What Do You Want Us to Do?”: Patients’ Rights, Unintended Consequences, and the Surrogate’s Role
Mark P. Aulisio

Death at the Beginning: The Neonatal Intensive Care Unit
Renee D. Boss

Dying Children and the Kindness of Strangers
John D. Lantos

Medical Futility and Potentially Inappropriate Treatment
Douglas B. White and Thaddeus M. Pope

Conscientious Objection
Mark R. Wicclair

Continuous Sedation at the End of Life
Sigrid Sterckx and Kasper Raus

The Ethics of Medically Assisted Nutrition and Hydration at the End of Life: Separating the Wheat from the Chaff
Daniel P. Sulmasy

Disorders of Consciousness and Neuro-Palliative Care: Toward an Expanded Scope of Practice for the Field
Joseph J. Fins and Maria G. Master

Ethical Issues in Prognosis and Prognostication
Alexander K. Smith and Paul Glare

The Smell of Chlorine: Coming to Terms with Death
Stuart J. Youngner

Talking and Working with Dying Patients: True Grief and Loss
Lisa Humphrey

The Nature of Suffering
Eric J. Cassell

On Our Difficulties Speaking to and About the Dying
David Barnard

The Cost of Dying Among the Elderly in the United States: Ethical Issues
Susannah L. Rose and Janelle Highland

Death, Dying, and the Disabled
Anita Silvers and Leslie P. Francis

The Effect of Social Media on End-of-Life Decision Making
Jessica Berg

Cultural Factors
Megan Crowley-Matoka

Ethnicity as a Factor
Kimberly S. Johnson and Ramona L. Rhodes

Reframing Care in End-of-Life Care Helpful Themes from a Catholic-Christian Understanding of Death
Michael McCarthy and Mark Kuczewski

Physician-Assisted Death in the Netherlands
Gerrit Kimsma

The Case Against Physician-Assisted Suicide and Euthanasia
Ira Byock

Goodbye, Thomas: The Case for Physician-Assisted Dying
Margaret P. Battin

Depression and the Desire to Die Near the End of Life
Nathan Fairman and Scott A. Irwin

Hospice and Palliative Care: Developments, Differences, and Challenges
David Clark

Potential Perils to the Promise of Specialty Palliative Care
Robert M. Arnold

Marketing Palliative Care
Bridget Tracy and Rolfe Sean Morrison

October 18, 2016

Margot Bentley - VSED Denied

In our 200+ participant conference on VSED, this weekend, we had 10 sessions with around 40 presenters.  But we had only one standing ovation: for Katherine Hammond's compelling presentation on her mother, Margot Bentley.  

The photo below attests to Margot Bentley’s vegetative condition. In the advance directive she signed when she was healthy, Margot asked that she not be fed or nourished if she developed an incurable condition. The document is neither recognized by the courts nor the nursing home.

The case is back in the news, because a care provider breached confidentiality to comment during the last round of media coverage.  

October 17, 2016

DNR without Consent in British Columbia - Zaixing Wang

A new case in British Columbia is reminiscent of
the many Ontario cases brought by Joy Wawrzyniak on behalf of her father Douglas DeGuerre.

Clinicians refused to resuscitate Zaixing Wang, because a doctor had written a DNR order on his medical chart.  His daughter never consented to the order and never even understood that one would be written.

But the attending physician told two review panels that he had explained his treatment plan to the family, including putting a DNR order on Wang’s chart in the event of “acute cardiopulmonary deterioration,” given his “poor pulmonary reserve.”

In the recently completed reviews, both the College of Physicians and Surgeons and Vancouver Coastal Health Authority’s Patient Care Quality Office accepted Lau’s statement that he had that conversation with the family.

This case may illustrated the challenge with obtaining only "assent" rather than consent when writing a DNR order on the basis of medical futility.  The family may not understand that clinicians will automatically implement the announced plan.

October 15, 2016

VSED - Hastening Death by Stopping Eating & Drinking

Today, we completed a two-day conference on VSED in Seattle. Compared to aid-in-dying, VSED has been the Cinderella of end-of-life research, largely neglected. This >200 participant conference is the first anywhere specifically focused on the...

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