Hot Topics: End of Life Care

Blog Posts (59)

February 9, 2015

Canadian Supreme Court: Legal Assisted Suicide In a Year

by Craig Klugman, Ph.D.

A year from now, all Canadians may have the right to assisted suicide. In February 6, the Canadian Supreme Court ruled “that the prohibition on physician-assisted dying is void insofar as it deprives a competent adult of such assistance where (1) the person affected clearly consents to the termination of life; and (2) the person has a grievous and irremediable medical condition (including an illness, disease or disability) that causes enduring suffering that is intolerable to the individual in the circumstances of his or her condition.” In other words, a competent and capacitated person with a serious and unresolvable condition that creates suffering has a right to have assistance to end his or her life.…

January 28, 2015

Still Alice: A Portrait of Familial Alzheimer’s Disease

by Craig M. Klugman, Ph.D.

This past weekend I spent a cold, snowy day in the theater watching the movie Still Alice.…

November 12, 2014

Wisdom Does Come with Age

<p style="line-height: 19.0400009155273px;">Reminders of our finitude always lurk close by, like <a href="http://www.theatlantic.com/features/archive/2014/09/why-i-hope-to-die-at-75/379329/">Ezekiel Emanuel's</a> article in last month's Atlantic, "Why I Hope to Die at 75." The head of the <a href="http://bioethics.nih.gov/about/">Clinical Bioethics Department</a> at the National Institutes of Health gives reasons for not living beyond 75: inevitable decline, disability, incapacity, and diminishment of "creativity, originality, and productivity." According to Emanuel, we wish to be remembered for our good years, prior to decline.</p> <p style="line-height: 19.0400009155273px;"><span style="line-height: 19.0400009155273px;">There are grains of truth here. Many of us "die" well before we are officially declared dead. I've seen patients kept alive for far too long in permanent vegetative states, while family dynamics, emotions, finances and scarce medical resources are depleted. We pay a high price for medical "progress." I also know thriving, vibrant elderly, themselves significantly disabled and incapacitated.</span></p> <p style="line-height: 19.0400009155273px;"><strong style="line-height: 19.0400009155273px; color: #34405b; font-family: Arial, Helvetica, sans-serif; font-size: 12px;">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 <a style="text-decoration: underline; color: #000099;" href="http://www.amc.edu/Academic/bioethics/index.cfm">website</a>.</strong></p>
November 12, 2014

Why the right to die movement needed Brittany Maynard

by Keisha Ray, Ph.D.

Brittany Maynard was diagnosed with brain cancer. At the age of 29 she decided to end her own life and “die with dignity” under Oregon’s “Death with Dignity Act.” There have been many articles written in support of Maynard’s choice and many articles written condemning her choice to die.…

November 5, 2014

Brittany Maynard: A Terminal Cancer Patient’s Controversial Choice

<p class="MsoNormal" style="line-height: 19.0400009155273px;"><span style="line-height: 22.3999996185303px;">The cover story of the October 27, 2014, issue of <a href="http://www.people.com/article/terminally-ill-brittany-maynard-decision-to-die">PEOPLE Magazine</a> featured Brittany Maynard, a 29-year-old Oregon woman with terminal brain cancer. </span><span style="line-height: 22.3999996185303px;">In the article, Ms. Maynard announced that she would end her life on November 1, 2014, on her own terms, availing herself of the physician-assisted suicide option under the 1997 Oregon<a href="http://public.health.oregon.gov/ProviderPartnerResources/EvaluationResearch/DeathwithDignityAct/Pages/index.aspx">Death With Dignity Act</a> (DWDA). </span><span style="line-height: 22.3999996185303px;">As planned, and according to her own schedule and timetable, she <a href="http://www.usatoday.com/story/news/nation-now/2014/11/02/brittany-maynard-/18390069/">died peacefully at home</a> – surrounded by family and friends – on Saturday, November 1. </span><span style="line-height: 22.3999996185303px;">She had signaled earlier in the week that she might <a href="http://www.usatoday.com/story/news/nation-now/2014/10/30/brittany-maynard-puts-off-ending-her-life/18166161/">delay taking her own life</a>, but in the end, it occurred as she <a href="http://www.washingtontimes.com/news/2014/oct/30/brittany-maynard-terminally-ill-cancer-patient-ret/">originally planned</a>.</span></p> <p class="MsoNormal" style="line-height: 19.0400009155273px;"><span style="line-height: 22.3999996185303px;"></span><span style="line-height: 22.3999996185303px;">In electing assisted suicide, Ms. Maynard said, “I’m choosing to put myself through less emotional and physical pain.” She continued, “I don’t want to die, but I’m dying. My cancer is going to kill me, and it’s a terrible, terrible way to die. … When I look at both options I have to die [dying from the cancer versus dying from an overdose], I feel this [a fatal dose] is far more humane.” But rethinking the possibilities after developing a rather extensive plan in orchestrating one’s death with a terminal illness is not that unusual either. Roughly 40% of those who obtain the lethal doses of medicine under Oregon’s DWDA in the end die not from suicide but disease. According to an article in </span><em style="line-height: 22.3999996185303px;"><a href="http://www.thenewatlantis.com/publications/ten-years-of-death-with-dignity">The New Atlantis</a></em><span style="line-height: 22.3999996185303px;">, written to report a 10-year experience under the DWDA, author Courtney Campbell wrote, “In ten years, 541 Oregon residents have received lethal prescriptions to end their lives; of this number, 341 patients actually ingested the drugs.”</span></p> <p class="MsoNormal" style="line-height: 19.0400009155273px;"><strong style="color: #34405b; font-family: Arial, Helvetica, sans-serif; font-size: 12px; line-height: 19.0400009155273px;">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 <a style="text-decoration: underline; color: #000099;" href="http://www.amc.edu/Academic/bioethics/index.cfm">website</a>.</strong></p>
November 4, 2014

GOVERNMENT IN THE SUNSHINE: ANNOUNCING THE RELEASE OF PLANNING MY WAY

by Ellen Fox, MD

It’s been five years since the media firestorm around “death panels” – a term coined by Sarah Palin to refer to a provision in Obamacare that would have authorized Medicare payments for advance care planning discussions.…

November 3, 2014

Rest in Peace Mrs. Maynard

by Craig Klugman, Ph.D.

Over this past weekend, Brittany Maynard took her own life. At 29-years-old, Mrs. Maynard took her prescription for assisted suicide to end her life before her terminal brain cancer pushed her into a quality of life that she found unacceptable.…

October 20, 2014

Death From Ebola: What do we do with the deceased?

by Craig Klugman, Ph.D.

In the United States in the year 1900, 52.6% of all deaths were due to infectious disease.…

September 24, 2014

Sophie’s Choice: Can Machines Do Any Better?

by Craig Klugman, Ph.D.

In the 1979 novel Sophie’s Choice by William Styron, the reader meets a Holocaust survivor who was forced in the camps to choose which of her two children would die immediately.…

September 18, 2014

A simple change? The IOM Report on “Dying in America”

by Craig Klugman, Ph.D.

Say there was a simple change that could be made to the health care system that would reduce cost, reduce demand, increase patient’s quality of life and satisfaction, address the whole patient and not just the disease, improve care coordination, and increase patient autonomy.…

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Published Articles (5)

American Journal of Bioethics: Volume 15 Issue 1 - Jan 2015

Ethical Obligations and Clinical Goals in End-of-Life Care: Deriving a Quality-of-Life Construct Based on the Islamic Concept of Accountability Before God (Taklīf) Aasim Padela & Afshan Mohiuddin

American Journal of Bioethics: Volume 14 Issue 8 - Aug 2014

Brain-Dead and Pregnant in Texas Thomas Wm. Mayo

American Journal of Bioethics: Volume 13 Issue 3 - Mar 2013

Withdrawal of Nonfutile Life Support After Attempted Suicide Samuel M. Brown, C. Gregory Elliott & Robert Paine

American Journal of Bioethics: Volume 13 Issue 3 - Mar 2013

Suicide and the Sufficiency of Surrogate Decision Makers Hywote Taye & David Magnus

AJOB Neuroscience: Volume 4 Issue 1 - Feb 2013

Communicating with the Minimally Conscious: Ethical Implications in End-of-Life Care Kathrine Bendtsen

News (362)

February 18, 2015 2:55 pm

Florida puts executions on hold as high court debates anesthetic

Florida’s highest court put executions on hold Tuesday while the U.S. Supreme Court decides whether use of a controversial general anesthetic constitutes “cruel and unusual” punishment of condemned killers.

January 26, 2015 2:49 pm

Golden years? Researcher explores longevity research and the companies banking on its success

Aging research, as we knew it in the 1990s and 2000’s, is being abandoned in favor of something much more ambitious. The central features of longevity research include an embrace of big data, a pivot away from studies hoping to find aging genes, a recognition that aging is best thought of a collection of diseases, not just one disease.
November 5, 2014 3:36 pm

How Long Have I Got Left?

The path forward would seem obvious, if only I knew how many months or years I had left. Tell me three months, I’d just spend time with family. Tell me one year, I’d have a plan (write that book). Give me 10 years, I’d get back to treating diseases.

November 5, 2014 3:36 pm

A conversation with a cancer patient about palliative care

Palliative care expert Timothy Quill held an intimate conversation with a Stanford neurosurgeon suffering from advanced lung cancer as an example of how physicians should talk to patients with serious illnesses about quality-of-life care.

August 12, 2014 1:54 pm

Briton with advanced heart failure launches new gene therapy trial

A 37-year-old British man who needs a mechanical pump to keep his heart working has kicked off tests to see if gene therapy could help him recover and potentially avoid the need for a heart transplant.

July 22, 2014 11:28 am

Germany allows seriously ill patients to grow their own cannabis

A German court ruled on Tuesday that some people suffering from chronic pain should be able to cultivate their own cannabis “for therapeutic purposes”.

June 23, 2014 1:55 pm

Critical Care Challenge: Dying with Dignity in the Intensive Care Unit

After a long ICU stay because of septic shock and multiple complications, a frail 77-year-old man had a fall and suffered an acute subdural hematoma and hemorrhagic contusion. Twelve days after evacuation of the subdural hematoma, he remains in a coma and is still receiving mechanical ventilation. How should decisions be made about further treatment?

June 3, 2014 2:01 pm

End-of-Life Doc Payment Plan Returns to the Fray

The federal government may reimburse doctors for talking to Medicare patients and their families about “advance care planning,” including living wills and end-of-life treatment options — potentially rekindling one of the fiercest storms in the Affordable Care Act debate.
May 19, 2014 2:46 pm

‘Right to Try’ laws spur debate over dying patients’ access to experimental drugs

Colorado, Missouri and Louisiana are poised to become the first states in the nation to give terminally ill patients the right to try experimental drugs without the blessing of the Food and Drug Administration, setting the stage for what could be a lengthy battle over who should decide whether a drug is too risky to try.

May 9, 2014 7:58 pm

For elderly hospital patients, CPR often has poor outcome: study

When older hospitalized patients need revival by CPR, more than half are likely to die before they are discharged, according to a new study.

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