Hot Topics: End of Life Care

Blog Posts (82)

May 14, 2015

Raging Against the Dying of the Light

by Craig Klugman, Ph.D.

When do we die? The legal and medical answer is we are dead when we either (a) have experienced total loss of all brain function or (b) cessation of cardiopulmonary activity.…

April 24, 2015

Human Remains for Compost: Repugnant or Resourceful?

<p><span style="font-size: 11.1999998092651px; line-height: 19.0400009155273px;">I am a lousy gardener. Just this year I am considering a small attempt at growing a few vegetables organically in my backyard. Maybe it was the long winter, maybe it is a drive to live more sustainably, maybe it is the challenge of overcoming decades of plant growing failures. After carefully selecting a few packets of easy to grow seeds and starting a few slow-growers inside, I have turned my attention to creating the best growing environment for these fragile plants. Part of this effort includes learning how to create compost from kitchen and yard waste materials. While I search for a suitable compost bin to take position behind the garage, I am diligently collecting fruit cores, egg shells, coffee grounds, and discarded greens in airtight containers in my fridge. Researching my options, I stumbled across an article that had me doing a double take, “A Project to Turn Corpses Into Compost” in the </span><a style="font-size: 11.1999998092651px; line-height: 19.0400009155273px;" href="http://www.nytimes.com/2015/04/14/science/a-project-to-turn-corpses-into-compost.html?action=click&amp;contentCollection=N.Y.%20%2F%20Region&amp;module=MostEmailed&amp;version=Full&amp;region=Marginalia&amp;src=me&amp;pgtype=article&amp;_r=0">New York Times</a><span style="font-size: 11.1999998092651px; line-height: 19.0400009155273px;"> online. I gasped in horror. Could this possibly be an ethical option for burial? Could this be legal? Was this environmentally safe? Was this a joke?</span></p> <p><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="color: #000099; text-decoration: underline;" href="http://www.amc.edu/Academic/bioethics/index.cfm">website</a>.</strong><span style="color: #34405b; font-family: Arial, Helvetica, sans-serif; font-size: 12px; line-height: 19.0400009155273px;"> </span></p>
March 31, 2015

Terri Schiavo: Ten Years Later

by Craig Klugman, Ph.D.

Today acknowledges the tenth anniversary since the final death of Terri Schiavo. Her feeding tube was removed on March 18 and her body took its last breath on March 31, 2005.…

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.…