Blog Posts (3493)
October 20, 2016
On 16 October 2016, Board members composed of country focal points and the secretariat met in Cairo and discussed the structure and function of the BiNWIAR. They reviewed activities of the network carried out since 2011, discussed the way to … Continue reading →
October 19, 2016
I just received my hard copy of The Oxford Handbook of Ethics at the End of Life. I am delighted to be a part (see chapter five on futility) of this fantastic anthology. Here is the complete table of contents.
Introduction Stuart J. Youngner and Robert M. Arnold
Legal Issues in Death and Dying: How Rights and Autonomy Have Shaped Clinical PracticeAlan Meisel
“So What Do You Want Us to Do?”: Patients’ Rights, Unintended Consequences, and the Surrogate’s RoleMark P. Aulisio
Death at the Beginning: The Neonatal Intensive Care UnitRenee D. Boss
Dying Children and the Kindness of StrangersJohn D. Lantos
Medical Futility and Potentially Inappropriate TreatmentDouglas B. White and Thaddeus M. Pope
Conscientious ObjectionMark R. Wicclair
Continuous Sedation at the End of LifeSigrid Sterckx and Kasper Raus
The Ethics of Medically Assisted Nutrition and Hydration at the End of Life: Separating the Wheat from the ChaffDaniel P. Sulmasy
Disorders of Consciousness and Neuro-Palliative Care: Toward an Expanded Scope of Practice for the FieldJoseph J. Fins and Maria G. Master
Ethical Issues in Prognosis and PrognosticationAlexander K. Smith and Paul Glare
The Smell of Chlorine: Coming to Terms with DeathStuart J. Youngner
Talking and Working with Dying Patients: True Grief and LossLisa Humphrey
The Nature of SufferingEric J. Cassell
On Our Difficulties Speaking to and About the DyingDavid Barnard
The Cost of Dying Among the Elderly in the United States: Ethical IssuesSusannah L. Rose and Janelle Highland
Death, Dying, and the DisabledAnita Silvers and Leslie P. Francis
The Effect of Social Media on End-of-Life Decision MakingJessica Berg
Cultural FactorsMegan Crowley-Matoka
Ethnicity as a FactorKimberly S. Johnson and Ramona L. Rhodes
Reframing Care in End-of-Life Care Helpful Themes from a Catholic-Christian Understanding of DeathMichael McCarthy and Mark Kuczewski
Physician-Assisted Death in the NetherlandsGerrit Kimsma
The Case Against Physician-Assisted Suicide and EuthanasiaIra Byock
Goodbye, Thomas: The Case for Physician-Assisted DyingMargaret P. Battin
Depression and the Desire to Die Near the End of LifeNathan Fairman and Scott A. Irwin
Hospice and Palliative Care: Developments, Differences, and ChallengesDavid Clark
Potential Perils to the Promise of Specialty Palliative CareRobert M. Arnold
Marketing Palliative CareBridget Tracy and Rolfe Sean Morrison
October 19, 2016
My article with Peter Bach of Memorial Sloan Kettering continues to generate debate. The two of us argues that copay assistance programs from pharmaceutical companies help specific patients in the short run, but make it easier for drug companies to … Continue reading →
The post Copay Assistance Controversy Continues appeared first on PeterUbel.com.
October 18, 2016
By Amy Blair I was not sure I wanted to be a physician when I stood in front of the dark blue US mail box on the street corner of my college campus, one hand on the door handle and the other on my neatly typed applications, hesitant to let them go. I wanted an […]
October 18, 2016
For bisexual female adolescents, proper sexual healthcare is difficult to obtain due to healthcare providers’ judgmental attitudes and assumptions of patient heterosexuality, and lack of opportunities for HIV and sexually transmitted infections (STI) testing. Additionally, youth openness with healthcare providers is restricted due … Continue reading →
October 18, 2016
In our 200+ participant conference on VSED, this weekend, we had 10 sessions with around 40 presenters. But we had only one standing ovation: for Katherine Hammond's compelling presentation on her mother, Margot Bentley.
The photo below attests to Margot Bentley’s vegetative condition. In the advance directive she signed when she was healthy, Margot asked that she not be fed or nourished if she developed an incurable condition. The document is neither recognized by the courts nor the nursing home.
The case is back in the news, because a care provider breached confidentiality to comment during the last round of media coverage.
October 18, 2016
The Presidential Commission for the Study of Bioethical Issues (Bioethics Commission) has released a set of new educational materials focused on democratic deliberation in public health ethics. This set of training materials builds on the content of the Bioethics Commission’s report, Bioethics for Every Generation: Deliberation and Education in Health, Science, and Technology.
October 17, 2016
The Presidential Commission for the Study of Bioethical Issues bioethics_twitter-v3-08(Bioethics Commission) has
released the sixth episode, "New Directions", in its new
podcast series Ethically Sound. This podcast series is dedicated to bringing the Bioethics Commission’s body of work to a broad audience. The Bioethics Commission, established in 2009 by President Bara
ck Obama, has produced 10 reports, each of which focuses on key ethical considerations surrounding a particular topic. Today’s episode is based on the Bioethics Commission’s first report, New Directions: The Ethics of Synthetic Biology and Emerging Technologies.
October 17, 2016
A new case in British Columbia is reminiscent of
the many Ontario cases brought by Joy Wawrzyniak on behalf of her father Douglas DeGuerre.
Clinicians refused to resuscitate Zaixing Wang, because a doctor had written a DNR order on his medical chart. His daughter never consented to the order and never even understood that one would be written.
But the attending physician told two review panels that he had explained his treatment plan to the family, including putting a DNR order on Wang’s chart in the event of “acute cardiopulmonary deterioration,” given his “poor pulmonary reserve.”
In the recently completed reviews, both the College of Physicians and Surgeons and Vancouver Coastal Health Authority’s Patient Care Quality Office accepted Lau’s statement that he had that conversation with the family.
This case may illustrated the challenge with obtaining only "assent" rather than consent when writing a DNR order on the basis of medical futility. The family may not understand that clinicians will automatically implement the announced plan.
October 15, 2016
Today, we completed a two-day conference on VSED in Seattle. Compared to aid-in-dying, VSED has been the Cinderella of end-of-life research, largely neglected.
This >200 participant conference is the first anywhere specifically focused on the...
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October 19, 2016 8:00 am
Cancer patients taking high doses of opioid painkillers are often afflicted by a new discomfort: constipation. Researcher Jonathan Moss thought he could help, but no drug company was interested in his ideas for relieving suffering among the dying.
October 18, 2016 8:00 am
Last year, Bob Nore, a Vietnam War veteran in Huntsville, Ala., was working on a family tree and wanted to trace his ancestors’ history and origins. So he sent a vial of saliva and $89 to a DNA registry for analysis.
October 17, 2016 8:00 am
The Institute of Medicine recently highlighted that physician diagnostic error is common and information technology may be part of the solution.1 Given advancements in computer science, computers may be able to independently make accurate clinical diagnoses.2 While studies have compared computer vs physician performance for reading electrocardiograms,3 the diagnostic accuracy of computers vs physicians remains unknown. To fill this gap in knowledge, we compared the diagnostic accuracy of physicians with computer algorithms called symptom checkers.
October 14, 2016 4:47 pm
Doctors are much better than symptom-checker programs at reaching a correct diagnosis, though the humans are not perfect and might benefit from using algorithms to supplement their skills, a small study suggests.
October 13, 2016 8:00 am
One of Theranos Inc.’s biggest financial backers has sued the embattled startup and its founder for allegedly lying to attract its nearly $100 million investment, according to a fund document and people familiar with the matter.
October 12, 2016 8:00 am
I work in Boston’s Longwood Medical Area, one of the densest concentrations of hospitals in the country, and I often have this reaction when I’m out on the street among my work neighbors: “Dude. Ew.”
October 7, 2016 8:00 am
By the time 8-year-old Ava Christianson got to the National Institutes of Health this summer, she had lost several grueling rounds to leukemia and was bracing for the next one.
October 5, 2016 8:00 am
Louis Casanova is playing cards with a friend on the back deck of a recovery house in Philadelphia’s northern suburbs.
October 3, 2016 8:00 am
Public anger over the cost of drugs has burned hot for a year, coursing through social media, popping up on the presidential campaign, and erupting in a series of congressional hearings, including one last week over the rising price of the allergy treatment EpiPen.
September 29, 2016 8:00 am
Depression, stress and diet can all alter inflammation. This double-blind, randomized crossover study addressed the impact of daily stressors and a history of major depressive disorder (MDD) on inflammatory responses to high-fat meals. During two separate 9.5 h admissions, 58 healthy women (38 breast cancer survivors and 20 demographically similar controls), mean age 53.1 years, received either a high saturated fat meal or a high oleic sunflower oil meal. The Daily Inventory of Stressful Events assessed prior day stressors and the Structured Clinical Interview for DSM-IV evaluated MDD. As expected, for a woman with no prior day stressors, C-reactive protein (CRP), serum amyloid A (SAA), intercellular adhesion molecule-1 (sICAM-1) and vascular cell adhesion molecule-1 (sVCAM-1) were higher following the saturated fat meal than the high oleic sunflower oil meal after controlling for pre-meal measures, age, trunk fat and physical activity. But if a woman had prior day stressors, these meal-related differences disappeared—because the stressors heightened CRP, SAA, sICAM-1 and sVCAM-1 responses to the sunflower oil meal, making it look more like the responses to the saturated fat meal. In addition, women with an MDD history had higher post-meal blood pressure responses than those without a similar history. These data show how recent stressors and an MDD history can reverberate through metabolic alterations, promoting inflammatory and atherogenic responses.
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