Hot Topics: Health Care

Blog Posts (2054)

July 1, 2015

Sexual morality and the goodness of God

Last week I wrote about Robert George’s presentation at the CBHD summer conference. He expressed very clearly how important the difference is between seeing human beings as a unity of spirit and body and seeing human beings as non-bodily persons who inhabit and use non-personal bodies. We have seen one of the implications of that difference play itself out this week in the Supreme Court... // Read More »
June 30, 2015

Estate Planning In the 21st Century: Seismic Shifts and Predictions for the Future - CFP

Estate Planning in the 21st Century:  Seismic Shifts and Predictions for the Future The American College of Trust and Estate Counsel (ACTEC Law Journal) announces a Call For Papers on the following topics:   Estate planning has radical...
June 30, 2015

Vanitas [EOL in Art 51]

Vanitas (by Peter Claesz) means "emptiness" - the meaninglessness of earthly life and the transient nature of vanity.
June 30, 2015

Ethical Issues at the End of Life - CFP

The Journal of Social Work in End-of-Life & Palliative Care has a CFP for a special thematic issue on ethical issues at the end of life.
June 29, 2015

Jahi McMath - Children's Hospital Demurrer

Following last week's demurrer by Defendant Rosen, this week, Children's Hospital Oakland filed its own demurrer in the medical malpractice action filed by the family of Jahi McMath.   Almost the entire brief is devoted to the question of her sta...
June 29, 2015

Judge Strikes California Law that Allowed Nursing Homes to Make Medical Decisions for Unbefriended Residents

I just updated my prior articles on decision making for adult orphans, unbefriended, unrepresented patients without surrogates (forthcoming 26(2) J Clinical Ethics).  And then this.

A California law allowing nursing homes to make medical decisions on behalf of certain mentally incompetent residents is unconstitutional, a state court ruled this week.

The law, which has been in effect more than 20 years, gave nursing homes authority to decide residents’ medical treatment if a doctor determined they were unable to do so and they had no one to represent them.

Alameda County Superior Court Judge Evelio M. Grillo wrote in the June 24 decision that the law violates patients’ due process rights because it doesn’t require nursing homes to notify patients they have been deemed incapacitated or to give them the chance to object.

Grillo acknowledged the decision is likely to “create problems” in how nursing home operate but wrote that patients’ rights are more compelling.

“The stakes are simply too high to hold otherwise,” the judge wrote. Any error could deprive patients of their rights to make medical decisions that “may result in significant consequences, including death.”

The medical decisions on incapacitated residents without representatives are made by a team that includes a physician and a nurse.

The fact that nursing homes are making end-of-life decisions without patient input is a big concern, according to the ruling. The decision cited one nursing home resident who was found to be mentally incapacitated and who had no representative. The facility staff made a decision to take him off life-sustaining treatment and he passed away in 2013.

The ruling came after the California Advocates for Nursing Home Reform, an advocacy group, filed a lawsuit in 2013 against the state Department of Public Health. The suit alleged that nursing homes used the law to administer anti-psychotic drugs, place residents in physical restraints and deny patients life-sustaining treatment.

Tony Chicotel, a staff attorney for the group, said the ruling will dramatically impact the lives of the most vulnerable nursing home residents.

“What [nursing homes] used to do was routinely make decisions big and small for their residents without really any regard to due process,” Chicotel said. “Now the residents are finally going to have their rights acknowledged and honored.”

Even patients who are compromised should still have a say in their medical care, he added.

“They have been ignored,” he said. “Unrepresented residents and the way they are treated in nursing homes has never been a priority of the Department of Public Health.”

The department is reviewing the decision, a spokesman said. Department officials declined to comment further or say whether they planned to appeal.

The law was enacted in 1992 because nursing facilities needed a way to give medical treatment to their incapacitated residents without having to wait up to six months for state approval, according to the ruling.

But the decision could make it challenging for nursing homes to provide routine medical care or to offer hospice care to residents who lack the mental capacity to make their own decisions and have no designated representatives, said Mark Reagan, an attorney representing the trade group, California Association of Health Facilities, which is not part of the lawsuit.

“If the person objects, then what?” Reagan said. “That can put patients and facilities in a difficult place.”

And seeking court approval to provide anti-psychotic medication to residents who truly need it would be costly and time-consuming for nursing facilities, he said. “How do you keep that person safe and how do you keep the other residents of the skilled nursing facility safe?” he said.

Reagan believes the ruling could have an unanticipated outcome: Patients without decision-makers could have a hard time finding a nursing facility willing to take them.

“If this decision makes it more difficult to supply necessary care at the bedside, this population is going to be less served,” he said.

The judge, however, wrote that informing patients and allowing them to object is not likely to result in any significant burdens on nursing homes.

Golden Gate University Law School Professor Mort Cohen, who filed the case, said the next step is for the judge to issue an order directing the state Department of Public Health, which oversees nursing homes statewide. The state could ask the court for a stay or could appeal the decision, but Cohen said he expects the decision to stick.

[From Kaiser Health News (KHN), a nonprofit national health policy news service.]
June 29, 2015

iPhone App Will Track Sexual Activity and Reproduction

<div style="font-size: 11.1999998092651px; line-height: 19.0400009155273px;">Apple recently announced that they will update their health app, HealthKit, to include reproductive health. Many were critical of the original app because although it can track a wide range of health indicators, such as BMI, sleep, sodium intake, number of falls, etc., it neglected reproductive health. Specifically, <a href="http://fusion.net/story/100781/apple-ios-update-new-version-of-healthkit-still-doesnt-track-periods/">it is problematic</a> that the app includes some obscure health indicators, like selenium intake, but not menstrual cycle, which affects half of the population. While there are other apps that are specifically geared toward women's reproductive health, it is troubling that an iPhone app that comes standard with the phone would exclude something so central to women's health as menstruation. Some believe that the omission of reproductive health from HealthKit is due to the fact that the tech world, including Apple, is dominated by men.  </div> <div style="font-size: 11.1999998092651px; line-height: 19.0400009155273px;"><br /></div> <div style="font-size: 11.1999998092651px; line-height: 19.0400009155273px;">The new the updated app is a huge improvement because it includes a variety of reproductive health indicators like menstruation, basal body temperature, and spotting. The broad range of reproductive health indicators helps women keep track of their reproductive health in general and specifically for women looking to prevent pregnancy and for women looking to achieve pregnancy. This is an important addition because too often reproductive health is overlooked or not considered part of "real" healthcare. The addition of the reproductive health category in HealthKit technology not only acknowledges the reproductive health issues specific to many women, but also normalizes them.</div> <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></p>
June 29, 2015

Relics - Film on Assisted Death [EOL in Art 50]

Relics is a 15-minute film about a salesman who tries to sell his miraculous cleaning machine to a sick woman and her skeptical daughter, on the day that the woman asked her daughter to help her end her own life. It's a comedy! Sort of... Relics scree...
June 29, 2015

Support Informing Bioethics Policy

This week, I added a Paypal donation button to my website to help cover cost, such as obtaining court documents from PACER and state court websites.  I want to thank the first four individuals (L.I., S.D., S.C., and T.P.) who donated.
June 28, 2015

Heartfelt - Photography of Troubled Births [EOL in Art 49]

Heartfelt is a volunteer organisation of professional photographers from all over Australia dedicated to giving the gift of photographic memories to families that have experienced stillbirths, premature births, or have children with serious and termina...

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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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