Tag: syndicated

Blog Posts (3643)

January 15, 2017

A Clinician's Guide to Privacy and Communication in the ICU

Make your staff read this short article in Critical Care Medicine.  So many clinicians believe that HIPAA constrains their ability to communicate with patient's families far more than it really does. This expert analysis helps bust those myths. ...
January 14, 2017

Speaking of Dying - Screening in Saint Paul, MN

Film Screening and Discussion on Tuesday, January 31, 2017 from 7 pm - 8:30 pm at Clouds in Water Zen Center, 455 N Farrington Street, St Paul, MN 55103

Speaking of Dying” captures the importance of individuals and groups   speaking openly about all aspects of the dying process. The interviews and stories in this 30-minute documentary reveal the complexities of end-of-life  choices while demonstrating resources and attitudes that can empower us. Most of all this will help you believe that your can have a peaceful and meaningful ending that will be a gift to you and to your loved ones. 

Facilitated by Laurel Riedel, Advanced Practice RN  speakingofdyingmn@gmail.com or 612-868-4116
Find us on Facebook: Speaking of Dying Minnesota

January 14, 2017

Federal Legislation to EXCLUDE Advance Care Planning under Medicare

Congressman Steve King has re-introduced a bill to exclude coverage of advance care planning services under the
Medicare program. 

Unfortunately, King fundamentally either misunderstands or deliberately mischaracterizes the current program, which is focused on soliciting and honoring the individual's own treatment preferences, not about limiting or constraining choice in any way.

"My legislation prohibits Medicare payments for end-of-life counseling, blocking this harmful regulation before our government imposes yet another life-devaluing policy on the American people. ”   

“A year ago this month, the government increased control over one of the most highly personal healthcare decisions an individual can make when the Centers for Medicare and Medicaid Services (CMS) began paying doctors to counsel patients about end-of-life care."

"Allowing the federal government to marry its need to save dollars with the promotion of end-of-life counseling is not in the interest of millions of Americans who were promised life-sustaining care in their older years in exchange for their compelled funding of the program during their working years. 

"Furthermore, this exact provision was removed from the final draft of Obamacare in 2009 as a direct result of public outcry. The worldview behind the policy has not changed since then and government control over this intimate choice is still intolerable to those who respect the dignity of human life."

January 13, 2017

Fordham University’s Dr. Celia B. Fisher on Bystander Apathy

  Since the election of Donald Trump in November, there has been a 35 percent increase in hate crimes across New York City, according to Straus News.  Throughout the presidential campaign, reported NYPD statistics of the city’s hate crime count has doubled in a year with 43 incidents in the 27 days following the election. The … More Fordham University’s Dr. Celia B. Fisher on Bystander Apathy
January 13, 2017

Physician Power to Declare Death by Neurologic Criteria Threatened

My new article with Ariane Lewis is now available from NEUROCRITICAL CARE - "Physician Power to Declare Death by Neurologic Criteria Threatened."

Background
Three recent lawsuits that address declaration of brain death (BD) garnered significant media attention and threaten to limit physician power to declare BD.

Methods
We discuss these cases and their consequences including: the right to refuse an apnea test, accepted medical standards for declaration of BD, and the irreversibility of BD.

Results
These cases warrant discussion because they threaten to: limit physicians’ power to determine death; incite families to seek injunctions to continue organ support after BD; and force hospitals to dispense valuable resources to dead patients in lieu of patients with reparable illnesses or injuries.

Conclusions
Physicians, philosophers, religious officials, ethicists, and lawyers must work together to address these issues and educate both the public and medical community about BD.

January 12, 2017

Fetal tissue research furor continues

At the end of 2016, the Select Investigative Panel of the House Energy and Commerce Committee published its report—all 485 pages—of its investigation into procurement of tissue from aborted fetuses for research.  The investigation had been prompted by the 2015 undercover videos from David Daleiden and his “Center for Medical Progress,” which was adduced to support charges that Planned Parenthood clinics, in particular, had violated... // Read More »
January 12, 2017

Southeast VSED End-of-Life Choice Conference

Voluntarily Stopping Eating and Drinking - VSED as it is called by Hospice and health providers - is an accessible option for the compassionate easing of the pain, suffering, and humiliation of life-limiting illness. VSED is a legal option in all 50 states for a competent adult who wishes to hasten the onset of their death.

Americans assert that they ought to have the freedom to choose in their daily lives.  And certainly, we all mourn the circumstances that may bring an individual and their loving family to the decision to step away from life. But in the real world, there are times when an individual will reach out for control at the end of their own life.  At such a time, that freedom to choose may involve scheduling the time, deciding the place, and selecting the process that seems appropriate to ease away from life.  

We should all be aware that VSED is unique – it is legal, accessible, and supported by medical personnel in every state in the United States. It is time that we gained more understanding about the various aspects of VSED – for the patient and for the family caregiver. That is the purpose of the  Southeast VSED End-of-Life Choice Conference.

Many will be surprised to learn that once informed about VSED, patients choose to experience it.  VSED allows an individual to comfortably ease away, to still interact with family and friends, and to feel that their passing is a more natural process.  For those who focus on Oregon-style medical-aid-in-dying, they sometimes need to be reminded that thousands of patients will be left without a timely option.  Yet these patients and their families do have the option of compassionate VSED.

Explore the dedicated website on the VSED 2017 Conference.

January 12, 2017

Who Has the Right to Turn Off Donald Trump's Artificial Heart?

In one of his recent Gresham College lectures, Professor Martin Elliott discusses  how with today's medical technology and Donald Trump's money, he might be able to prolong his biological life indefinitely.   Is that appropriate?  Who s...
January 11, 2017

Flatulence and Elections

Approximately once a month I open my schedule and see that my first task of the day is to write a post for the Alden March Bioethics Blog, Bioethics Today. The first part of this task is to determine what to write about. Sometimes that is the most difficult part of the job. I try to give myself fairly wide discretion in choice of topics but this is a bioethics blog so I do try to be conscientious about finding some relationship between the topic of the blog and bioethics. Sometimes that is hard. Recently while perusing the venerable Washington Post I came upon an article that I felt I had to write a blog about.

It also happened that today was the day that my calendar told me it was time to write a blog. So here goes.

It was reported today that there was a fire in the operating room April 15 during a surgical procedure. An unidentified woman was undergoing a surgical procedure on the cervix with a laser. To make a long story short, the woman passed gas, the laser ignited the flatulence and the surgical draping caught fire.

I was attracted to this article because I used to be a young boy (this was a very long time ago) and all young boys believe that everything about farts is funny and entertaining. It was even more entertaining when the flatulence was ignited. Alas when I first saw the article I thought it would be funny but it was not. The woman was seriously burned.  This no longer seemed like a good topic for a blog and I left it incompletely written and unpublished.

While this happened months ago it is current again. At least in my thinking it has become current. The reason for this is that sometimes things that start out seeming funny or absurd become serious issues. I admit that only months ago I thought that the fact that a certain individual was running for president was both funny and absurd. Now he has been elected and it seems neither funny nor absurd. It seems very serious indeed.

So now in my mind the presidential election process evokes thoughts of a woman who was seriously burned in a fire ignited by her own flatulence. I hope the nation and the world are not seriously burned by this election but I fear they will be.

The Alden March Bioethics Institute offers a Master of Science in Bioethics, a Doctorate of Professional Studies in Bioethics, and Graduate Certificates in Clinical Ethics and Clinical Ethics Consultation. For more information on AMBI's online graduate programs, please visit our website.

 

 

January 11, 2017

Bishop Tutu’s Plea Prompts Personal Meditation on Assisted Suicide

By Myra Christopher
I worked late Tuesday night and was listening to NPR as I always do during my short commute home when I heard that, in celebration of his 85th birthday, Bishop Desmond Tutu announced that he supports physician-assisted suicide and “prays that politicians, lawmakers and religious leaders have the courage to support the choices that terminally ill citizens make in departing Mother Earth with dignity and love.” I was stunned.

At age 30, I decided to spend my life working to improve end-of-life care and that the way that I would do that would be by “doing ethics.” I would spend my life arguing that the seriously ill and dying have an inherent right to a “dignified death.” This year I will be 70, and I have had a long and interesting career. Over the past 40 years, the issues of euthanasia and physician-assisted suicide have been what I considered as recurring distractions from what I have thought to be really important, i.e., advancing palliative care. Bishop Tutu’s comments, however, cannot and should not be considered by any one as simply a “distraction.” I believe they are a “game-changer.”

In the late 1990s, I directed Community-State Partnerships to Improve End-of-Life Care, an $11.25m Robert Wood Johnson (RWJ) Foundation grant award program. At about the same time, Jack Kevorkian – or Dr. Death as he came to be known – came on to the public scene. At a national conference, I was asked what I thought of Dr. Kevorkian, and I said without hesitating that I thought he was a murderer and should be imprisoned.

Envisioning Other Options

After the conference, a communication officer from the RWJ Foundation asked me if I knew the data regarding public views on physician-assisted suicide. I said that, of course, I did – 50% of Americans were for it and 50% were against it. She said, “You realize that when you made the statement you did that half the audience turned you off,” and then asked me if I could imagine saying something like, “Physician-assisted suicide is something good people disagree about, but what we can all agree upon is that we must do a better job of caring for those who are seriously ill and dying so that they don’t see suicide as their only option.”

That statement made good sense to me and has served me well over the years. To clarify my personal view, I always add that I am against the “legalization” of assisted suicide but would NEVER pass moral judgment on a caring committed physician or loving family member who assisted a patient or loved one to die. Furthermore, I know that it happens all over the United States every day. Years ago, an article titled “It’s Over Debbie” was published in JAMA (Journal of the American Medical Society) in which a resident anonymously reported having euthanized a young woman in agonal pain dying of a terminal gynecological cancer. I got four calls, two of them from healthcare professionals in Kansas City, telling me that the caller was sure the event had occurred in their own hospital. 

Personal Choice and the Slippery Slope

I have shared in private conversations, however, that in certain situations, I would personally choose to end my own life and expect others to help me to do so if I were incapable of acting on my own behalf. I recognize the logical inconsistency of my thoughts and have felt hypocritical from time to time. But because so many people in the U.S. are not insured and do not have access to healthcare, especially good end-of-life care, and because we know without question that certain populations, e.g., people of color and those in lower socio-economic situations, receive less care, worse care and have poorer outcomes, I have felt that legalizing physician-assisted suicide could potentially make these people even more vulnerable…that it was just too risky. Even though the data from Oregon, the first state in the U.S. to legalize physician-assisted suicide, has not proven that to be true, my fear has been the “slippery slope,” i.e., if we allow competent people to make this choice, are we then far from deciding the same should be true for those who cannot make decisions for themselves. I still do not believe that concern is unfounded.

The Netherlands, the first country to legalize euthanasia, now allows others to make decisions about ending the lives of those who are unable to be self-determining. Furthermore, years ago, I debated this issue with Derek Humphry, Founder of the Hemlock Society, and when I asked him if he would support euthanizing people who had never been able to express their wishes, he said something like “not now.”

No Safe Harbor

Bishop Tutu
Ironically, in the early 2000s, two nurses in upstate New York who published an online newspaper called The North Country Gazette, decided that I was the leader of the euthanasia movement in the U.S. For several months, they published a “front-page” article about euthanasia and included my name in the headline. I wasn’t aware of it until I began to receive letters from children asking me why I wanted to kill their grandmother and got a couple of calls from national organizations with whom the Center was working asking me to clarify our position on euthanasia. (I should point out that the Center does not now nor has it ever had an official position on euthanasia. Members of the Center’s board and staff are not of one mind about this issue, and I suspect never will be.)

After hand-printing a few letters to children saying that I was not sure why they thought I would ever want to harm their grandmother, we learned the source of the perception. I honestly will never know why I became the target of this series. I do know, however, that it was heart-breaking to me that for nearly two years, if you Googled “euthanasia,” my name was the first thing to pop-up. 

Neither my ambivalence (or lack of intellectual clarity) nor my efforts to claim the moral high ground – or even what I thought to be clever communication strategies – had provided me a safe harbor or a pass from this debate.

A Moral Right

Now on Tuesday night, Bishop Desmond Tutu, a person who for years I have considered a global moral leader and personal hero, spoke with conviction and confidence about euthanasia as a moral right, an entitlement. 


Ethics is not about black and white. In my experience, it is clearly about trying to deal with “shades of gray.” But, from a philosophical perspective, respect for human life is not negotiable and that has been a sticking point for me. Tuesday night Bishop Tutu said, “As a Christian, I believe in the sanctity of life and that death is a part of life. I hope that when the time comes I am treated with compassion and allowed to pass on to the next phase of life’s journey in the manner of my choice.” I do too. 




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