Hot Topics: Health Care

Blog Posts (2168)

August 4, 2015

Overtreatment [EOL in Art 85]

More medicine is NOT always better.  
August 4, 2015

Report on Incorrect DNR Order from Veterans Affairs Inspector General

In October 2014, I blogged about the case of Roland Mayo.  A California VA facility had erroneously placed a DNR order on him.

A few days ago, the Department of Veterans Affairs Office of Inspector General released a new report titled "Healthcare Inspection: Delay in Emergency Airway Management and Concerns about Support for Nurses VA Northern California Health Care System Mather, California."

The OIG found:
  • Facility staff did not follow through on the patient’s request upon admission to discuss advance directives. We found no evidence of advance care planning discussion during the patient’s hospital stay.
  • The patient’s wristband had the incorrect code status of Do Not Resuscitate/Do Not Intubate printed on it and that staff did not verify the wristband code status during the patient’s 9-day hospital stay. 
  • The wristband had clinical warnings not pertinent to the patient’s current condition. We determined that a contributing factor as to why staff did not identify the incorrect code status might have been that nurses were using a duplicate copy of the wristband as a “workaround” when administering medications.
  • The incorrect code status on the patient’s wristband led to a delay in life-saving intervention. We concluded that code status confusion delayed chest compressions, defibrillation pad placement, and medications. The anesthesiologist was turned away and called back later, causing a delay in intubation. Of note, the patient was actively being managed by the code team physician during this time.

August 3, 2015

Are Healthcare Profits Unethical?

I recently spoke with Audiey Kao, an ethics expert at the American Medical Association. Our conversation has been released as a podcast. We talked about quite a few things, but the part I enjoyed the most involved a gentle disagreement … Continue reading

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August 3, 2015

Preparing for the End of Your Life (Minneapolis)

You are welcome to join "Preparing for the End of Your Life," a presentation by Compassion & Choices (Minnesota) President Janet Conn. WHEN:  Sunday, August 9, 2015, at 11:15 a.m. WHERE:  First Universalist Church (3400 Dupont Ave....
August 3, 2015

People with AIDS [EOL in Art 84]

Nicholas Nixon has devoted a significant portion of his career to taking portraits of people who are sick and dying. Two projects from the 1980s are "Photographs of Old People" and "People with AIDS." 
August 3, 2015

Legislation to Forbid Medicare Coverage of Advance Care Planning

I was really surprised (and annoyed) to see U.S. Representative Steve King, R-Iowa introduce H.R. 3251, the End-of-Life Counseling Bill.  The main section of the bill provides for "EXCLUSION OF COVERAGE OF ADVANCE CARE PLANNING SERVICES UNDER THE ...
August 2, 2015

Coerced Consent to Stop Life Sustaining Treatment

Only in rare and narrow circumstances does U.S. law permit
clinicians to stop life-sustaining treatment WITHOUT the consent of the patient or surrogate.  Therefore, the focus of many policies and guidelines is on getting that consent.

Unfortunately, that consent is often not informed or voluntary.  I have written about this before (for example, here and here).

Yesterday, in the Detroit Free Press David Blumenthal discusses how some physicians refer to themselves as "The Grim Reaper”  “Oh, just give me 10 minutes with the family, I’ll convince them to pull the plug.” 

Blumenthal observes that "the situation worsens when, often for cultural or religious reasons, families decide to continue aggressive care for their loved ones even after achieving a better understanding of the prognosis and painful course of illness. In these cases, the doctor, conditioned to hammer home the bad news expecting the family to eventually relent becomes, ultimately, callous."

"Because large medical teams rotate weekly, they often each feel the need to encourage reducing treatment, frequently ignoring families who I’ve seen plead for the subject not to be brought up again."

August 2, 2015

Last Day in Hospice [EOL in Art 83]

B.D. Colen took some impressive photographs of Bill Potter at a New Hampshire hospice where he was dying of lung cancer.  The black-and-white snapshots give a glimpse not only into Potter’s final hours, but also into his family’s efforts to surround and celebrate their loved one. 

August 1, 2015

The Personhood Problem

This week, a New York judge dismissed a case seeking to free and grant personhood to two chimpanzees being used in studies by Stoney Brook University. Manhattan Supreme Court Justice Barbara Jaffe issued a thirty-three page document outlining the reasoning behind her decision. A higher court had ruled on a similar case last year, so she was bound to follow suite. The Nonhuman Rights Project,... // Read More »
August 1, 2015

Grace Before Dying - Photographs of the Hospice Program at Louisiana State Penitentiary [EOL in Art 82]

Grace Before Dying is an award-winning photographic documentary by Lori Waselchuk that chronicles the prisoner-run hospice program at the Louisiana State Penitentiary, in Angola.  Waselchuk collaborated with the Angola Prison hospice volunteer qu...

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Published Articles (20)

American Journal of Bioethics: Volume 15 Issue 4 - Apr 2015

Ideology and Microbiology: Ebola, Science, and Deliberative Democracy Joseph J. Fins

American Journal of Bioethics: Volume 15 Issue 2 - Feb 2015

Collectivizing Rescue Obligations in Bioethics Jeremy R. Garrett

American Journal of Bioethics: Volume 15 Issue 2 - Feb 2015

Rethinking the Rescue Paradigm Kayhan Parsi

American Journal of Bioethics: Volume 14 Issue 9 - Sep 2014

Addressing Dual Agency: Getting Specific About the Expectations of Professionalism Jon C. Tilburt

American Journal of Bioethics: Volume 14 Issue 7 - Jul 2014

The Principle of Equivalence Reconsidered: Assessing the Relevance of the Principle of Equivalence in Prison Medicine Fabrice Jotterand & Tenzin Wangmo

American Journal of Bioethics: Volume 14 Issue 6 - Jun 2014

Patient and Citizen Participation in Health: The Need for Improved Ethical Support Laura Williamson

American Journal of Bioethics: Volume 14 Issue 2 - Feb 2014

Ethical Review of Health Systems Research in Low- and Middle-Income Countries: A Conceptual Exploration Adnan A. Hyder, Abbas Rattani, Carleigh Krubiner, Abdulgafoor M. Bachani & Nhan T. Tran

American Journal of Bioethics: Volume 14 Issue 2 - Feb 2014

Connecting Health Systems Research Ethics to a Broader Health Equity Agenda Bridget Pratt

American Journal of Bioethics: Volume 13 Issue 9 - Sep 2013

An Ethical Analysis of Mandatory Influenza Vaccination of Health Care Personnel: Implementing Fairly and Balancing Benefits and Burdens Armand H. Matheny Antommaria

American Journal of Bioethics: Volume 13 Issue 9 - Sep 2013

Vaccine Mandates Are Justifiable Because We Are All in This Together John D. Lantos and Mary Anne Jackson

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News (1987)

May 14, 2015 3:39 pm

U.S. says insurers must cover FDA-approved birth control methods

The U.S. government said health insurers must cover all FDA-approved methods of birth control without co-pays or charges to the patient, as it issued a paper on Monday looking to clarify coverage guidelines under the Affordable Care Act.

May 13, 2015 3:37 pm

Inhaler ban boosts costs for people with asthma

A 2008 ban on chlorofluorocarbons (CFCs) has ended up being particularly costly for people with asthma.  The inhaler switch “had minimal or no environmental benefits, but great benefits to pharmaceutical companies,” Redberg told Reuters Health by phone.

April 20, 2015 4:28 pm

Type, frequency of e-cigarette use linked to quitting smoking

Two new studies looking at whether electronic cigarettes help smokers to quit their deadly habit have found that while some of them can, it depends on the type and how often it is used.

March 19, 2015 1:44 pm

Industry makes $7,000 for each tobacco death: health campaigners

The tobacco industry makes $7,000 for each of the more than 6 million people who die each year from smoking-related illness, the health campaign group World Lung Foundation (WLF) said.

March 13, 2015 6:23 pm

Transgender people face discrimination in healthcare

Many transgender men face discrimination in U.S. healthcare settings, according to a new study.

March 11, 2015 6:29 pm

Online offers of personalized cancer medicine may not be trustworthy

Tumor tests, genetic risk analyses and other products or services sold online as personalized cancer medicine are often not backed by evidence, according to a new U.S. study.

March 10, 2015 6:43 pm

Electric 'noise' treats Parkinson's symptoms

A wearable device that stimulates the sense of balance with electric “noise” could help Parkinson’s disease patients, according to Swedish scientists.

March 9, 2015 6:28 pm

Seeing medical records might ease hospital patients’ confusion

Letting patients see their medical records while they’re in the hospital might ease worry and confusion without extra work for doctors and nurses, a small study suggests.

February 12, 2015 4:30 pm

Disabled elderly decline sharply after ICU

Seniors admitted to the hospital intensive care unit (ICU) were more likely to die or sharply decline soon after their release depending on how well they functioned beforehand, according to a new study.

January 30, 2015 2:50 pm

Obama thinks "precision medicine" will make us healthier. Experts are skeptical.

The White House is committing $215 million to support efforts to develop personalized medicine, a priority the President touched on in his State of the Union earlier this month.

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