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Blog Posts (3607)

December 6, 2016

Lessons Learned from a Beatbox Heart

By Tim Lahey Two days ago, Jimmy stuck a used needle into the soft skin of his forearm, and released 20 milligrams of black tar heroin and a bolus of bacteria into his blood. The bacteria floated from vein to artery as he nodded, eventually sticking themselves to the ragged edge of his aortic valve.  […]
December 6, 2016

Oliver Wendell Holmes on Death (audio from 1931)

Here is a recording of Oliver Wendell Holmes commenting about death in 1931 on his 90th birthday.  He retired from the court just a few weeks later. 

"In this symposium my part is only to sit in silence. To express one’s feelings as the end draws near is too intimate a task. But one thought that comes to me as a listener-in. The riders in the race do not stop short when they reach the goal. There is a little finishing canter before coming to a standstill. There is time to hear the kind voice of friends and to say to oneself that the work is done."

"But just as one says that, the answer comes: The race is over, but the work never is done while the power to work remains. The canter that brings you to a standstill need not be only coming to rest. It cannot be while you still live, but to live is to function. That is all there is. And so I end with a line from a Latin poet, who uttered the message more than fifteen-hundred years ago, Death, death, plucks my ear, and says, ‘Live. I am  coming.'"  (HT: John Blackman)

December 5, 2016

Looking Back at the Bioethics Commission’s Blog

Throughout its tenure, the Bioethics Commission has maintained an active digital presence to connect with a global audience. A major component of this has been through its blog. This final blog post reflects on the role the blog has played in disseminating the Bioethics Commission’s work.
December 5, 2016

Jahi McMath Defendants Seek to Unseal Transcripts

For three years, the family of Jahi McMath has made numerous public claims that she is alive.  

The medical defendants in her malpractice lawsuit now want to rebut those claims by using evidence presented during hearings in December 2013.  But those records are under seal.  The family opposes the defendants' joint motion, citing Jahi's right to confidentiality.  A hearing is scheduled for December 13, 2016.


Furthermore, for those wanting to "catch up" on what this case is all about, the plaintiffs’ opposition brief provides a nice recap of the medical malpractice claims.  It also provides a recap of the evidentiary basis that Jahi is now alive.  Highlighting is mine.


"Here, based upon medical experts' evaluations of Jahi since Judge Grillo's ruling in 2013, she no longer fulfills standard brain death criteria, due to her ability to specifically respond to stimuli. The distinction between random cord-originating movements and true responses to command is crucial to diagnosis of brain death. Jahi is capable of intermittently responding intentionally to a verbal command."


"Additionally, the international team of  medical experts who gathered to observe, test and analyze Jahi's unprecedented progress in the fall of 2014 saw evidence of brain activity in the EEG.  They observed the brain activity increase and become 'readily identifiable  and profound' when Jahi's mother spoke to Jahi.  A long and thorough MRI was conducted in which they 'unequivocally saw the presence of brain structure including the evidence of ribbons in the brain."

"This is critical as it showed that the brain, although damaged, was there structurally.'  Nine months after Jahi was declared brain dead, the experts 'would have expected to see her brain had liquefied. It clearly was not.' Additionally, the experts looked for evidence of blood flow.  'Blood flow was clearly evident. This does not happen if a patient is brain dead.'"


"In overruling Defendants' demurrer to Plaintiffs' personal injury claim, this Court has properly rejected Defendants' argument that once their physicians opined in December 2013 that Jahi was brain dead for the purpose of removing life support, her death became static, fixed and permanent, and Jahi is absolutely precluded from alleging and proving that she is, in fact, alive."



"To the contrary, her condition has changed dramatically since Judge Grillo's ruling in December 2013 - among other changes, there are vast areas of structurally and relatively preserved brain, tests demonstrate intracranial blood flow consistent with the integrity of the MRI and inconsistent with brain death, and Jahi underwent menarche (her first ovulation cycle) and began breast development."


December 4, 2016

Health Law Classes Online J Term 2017

Legal Compliance Essentials for Drug, Device, and Biotech Companies

Dr. Seth Whitelaw, J.D.
.
January 2-13, 2017
Online
2 J.D. credits
Approved for 15 on-demand standard CLE credits (event code: 227898)
Approved for 15 Regulatory Affairs Certification (RAC) Credits.
The Compliance Certification Board (CCB)® has approved this event for up to 10.8 CCB CEUs. Continuing Education Units are awarded based on individual attendance records. Granting of prior approval in no way constitutes endorsement by CCB of this program content or of the program sponsor

Faculty

Dr. Seth Whitelaw, J.D., Founder, Whitelaw Compliance Group, LLCSenior Fellow and Adjunct Professor, Life Sciences Compliance
Description

ccb-logo

The U.S. health care system is composed of three primary parts: providers, payers, and finally manufacturers (drug, device, and biotech companies). It is a complex, complicated, and challenging system of laws, regulations, cases, guidance and, in some cases, folklore. This course is designed for the current and future attorney or compliance professional supporting drug, device, and biotech companies. Students will gain a practical understanding of the laws, regulations, cases, and guidance they will encounter in daily practice. Also, upon completion, all participants will understand how to design and operate an effective company compliance program.

Textbook

O’Reilly, et. al, Food and Drug Administration, 4th ed. (can be accessed online via Westlaw)
Holland & Knight, Corporate Compliance Answer Book 2017, Practicing Law Institute

From Addiction to Zika: Current Issues in Public Health Law

Jill Krueger, J.D.

January 2-13, 2017
Online
2 J.D. credits
Faculty

Description

This course explores public health law through the lens of current issues in population health. Prescription drug overdose and the zika virus have captured the attention of both policy-makers and the public, as have topics such as gun violence, obesity, access to care, vaccine refusal, medical marijuana, and smoking. We will examine the leading causes of preventable death, disease, and injury, both in and out of the spotlight. Students will analyze the underlying social, economic, and environmental factors that contribute to or detract from community health and well-being, as well as legal strategies to address those factors. In the process, the course introduces students to the fundamentals of public health law, including those constitutional, statutory, and administrative laws that empower or mandate government to act to advance community health and those that curtail governmental power to do so.

Textbook

Required: Readings will be made available either through a bound supplement for sale in the bookstore, or through links on Blackboard.
Recommended: Public Health Law: Power, Duty, Restraint (3rd edition), Lawrence O. Gostin and Lindsay F. Wiley
December 4, 2016

Do Polls about PAS Tell the Whole Story?

By many indications, support for the legalization of physician-assisted suicide [PAS] is increasing. On November 8, 2016 Colorado voters passed Proposition 106, “Colorado End of Life Options Act,” by a 65% to 35% margin, making Colorado the sixth state to legalize PAS, joining Oregon, Washington, Montana, Vermont, and California. The following question appeared in a 2015 Gallup poll: “When a person has a disease that... // Read More »
December 4, 2016

Virginia Rejects Texas Futility Law and Opts to Further Study Legislation on Life-Sustaining Treatment Conflicts

Last month, the Virginia Joint Commission on Health Care decided not to move forward on specific proposals to amend the state Health Care Decisions Act.   If enacted, the VJCHC proposals would have made Virginia law similar to Texas law, by autho...
December 3, 2016

DAUGHTERS OF THE DUST, STANDING @ THE SCRATCH LINE: Bioethics meets real Cross Cultural Competency


Director July Dash (Daughters of the Dust and Scratch Line)
at the MVFF 39 October 14, 2016


As a member of  the National Writers Union and affiliate of  the International Federation of Journalists, it is my profound honor to represent the California Film Institute in presenting  director Julie Dash the Mill Valley Film Festival Award. This award honors the excellence of  her lifetime body of work.” —None of  these words could I have imagined coming from my mouth. But, on October 12, 2016, that is what I said at the 39th Mill Valley film festival. MVFF is one of the longest running Film Festival’s in North America with an audience this year of more than 65,000. 

Recently digitally remastered by the Coleman Library, director Dash’s DAUGHTERS OF THE DUST aesthetic remains incomparable with a message persistently timely. An African American family prepares to leave their Gullah Island home. They and their descendants have lived on that land since long before the Emancipation Proclamation. Tensions between the power of the familiar and perils of a new existence are made abundantly clear by a matriarch. She is a first degree relative to those brought as slaves from Africa. 

The re-released version of DAUGHTERS OF THE DUST, screened at the MVFF39, was preceded by the premiere of Dash’s provocative new short film, STANDING @ THE SCRATCH LINE. This new work is a part of the Great Migration Project. It lyrically traces the arrival of the first Africans on the Gullah Island shore their generations of migration from the Gullah Geechee Lowcountry to Philadelphia, PA. The film links the survival of a people to the strengths of the sacred architecture of African American Churches.

Filmmaker Julie Dash’s screen voice is an offspring of the “LA Rebellion”. The LA Rebellion creative movement emerged from the UCLA School of Theater, Film and Television  during the late 1960s and 1970s. The Rebellion was, and is, the bard of  complex justice issues, while also an anti-venom for racism and classism.

Twenty years after the LA Rebellion, in 1991,  internationally recognized, Julie Dash’s DAUGHTERS OF THE DUST, was the first feature-length film by an African American woman with United States theatrical release. The film coincided with a period when we, in clinical medical ethics, were defining the importance of cross-cultural communication in medicine — particularly at the edges of life — birth and death. 

The battle was to get an understanding of race class and culture into the medical curriculum. 
In a real way Ms. Dashs work help to combat health disparity across race, class and culture. Her's is an anthropological short hand bundling the reality of what had before been like talking only about the reflection of stars — Now, one can actually show the celestial body of cultural complexity to colleagues and say,  This is part of what you are working with when you diagnose a person with a life threatening illness, with its fears, attendant loss of family and culture. Director Julie Dash manages to demonstrate that a culture can be simultaneously different from others, while expressing universal concerns.

Other works by Ms. Dash are THE ROSA PARKS STORY,  INCOGNITO, FUNNY VALENTINES, LOVE SONG and SUBWAY STORIES. Coming soon is her film  TRAVEL NOTES OF A GEECHEE GIRL, about writer- actor-griot-culinary anthropologist Vertamae Smart-Grosvenor.

References:



Standing@the Scratch Line https://vimeo.com/180110116

Julie Dash official website: http://juliedash.tv


December 3, 2016

Speaking of Dying - End of Life Planning Workshop Minnesota

December 2, 2016

Respecting Choices and Disabilities Groups Collaborate on Decision Aids

It is wonderful to see disability organizations working together with advance care planning leader Respecting Choices. Some disability advocates expressed concerns that certain Respecting Choices decision aids (regarding medical nutritional and breath...

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Published Articles (35)

American Journal of Bioethics: Volume 16 Issue 12 - Dec 2016

A Broader Understanding of Moral Distress Stephen M. Campbell, Connie M. Ulrich & Christine Grady

American Journal of Bioethics: Volume 16 Issue 12 - Dec 2016

Moral Distress in Clinical Ethics: Expanding the Concept Alyssa M. Burgart & Katherine E. Kruse

American Journal of Bioethics: Volume 16 Issue 11 - Nov 2016

Diagnosis by Documentary: Professional Responsibilities in Informal Encounters Alistair Wardrope & Markus Reuber

American Journal of Bioethics: Volume 16 Issue 11 - Nov 2016

The Ethics of Organ Donor Registration Policies: Nudges and Respect for Autonomy Douglas MacKay & Alexandra Robinson

American Journal of Bioethics: Volume 16 Issue 11 - Nov 2016

Autonomy by Default Cass R. Sunstein

American Journal of Bioethics: Volume 16 Issue 10 - Oct 2016

War Metaphors in Health Care: What Are They Good For? Kayhan Parsi

American Journal of Bioethics: Volume 16 Issue 9 - Sep 2016

The Importance of Fostering Ownership During Medical Training Alex Dubov, Liana Fraenkel & Elizabeth Seng

American Journal of Bioethics: Volume 16 Issue 9 - Sep 2016

Owning Medical Professionalism Jon C. Tilburt & Richard R. Sharp

AJOB Primary Research: Volume 7 Issue 3 - Jul 2016

Religious identity and workplace discrimination: A national survey of American Muslim physicians Aasim I. Padela, Huda Adam, Maha Ahmad, Zahra Hosseinian & Farr Curlin

AJOB Primary Research: Volume 7 Issue 3 - Jul 2016

Improving third-year medical students' competency in clinical moral reasoning: Two interventions Paul J. Cummins, Katherine J. Mendis, Robert Fallar, Amanda Favia, Lily Frank, Carolyn Plunkett, Nada Gligorov & Rosamond Rhodes

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News (2061)

November 16, 2016 9:00 am

Too many people are being told they have a vitamin D deficiency (Washington Post)

Doctors are warning about vitamin D again, and it’s not the “we need more” news you might expect.

November 11, 2016 8:00 am

Colorado passes medical aid in dying, joining five other states (Denver Post)

Colorado passed a medical aid in dying measure Tuesday that will allow adults suffering from terminal illness to take life-ending, doctor-prescribed sleeping medication.

November 10, 2016 10:52 am

U.S. watchdog told Medicare, Medicaid that EpiPen was misclassified in 2009: senator (Reuters)

The internal watchdog at the U.S. Department of Health and Human Services warned the office tasked with administering federal health insurance programs that Mylan NV’s EpiPen was improperly classified as a generic drug in 2009, Senator Charles Grassley said on Tuesday.

November 7, 2016 8:00 am

Putting Sugary Soda Out of Reach (NY Times)

Can public health officials force Americans to break their soda habit?

November 7, 2016 8:00 am

Has a new mutation in the Ebola virus made it deadlier? (Science)

The sheer size of the Ebola epidemic that began in 2013 and engulfed West Africa is still a bit of a riddle for scientists. Previous Ebola outbreaks had never sickened more than 600 people. But the outbreak in Liberia, Sierra Leone, and Guinea infected more than 28,000 before it was finally brought under control. Part of the explanation was that the virus had suddenly surfaced in major cities, making it harder to stamp out than in the isolated rural locales where it had struck before. The countries’ poor public health infrastructure and other environmental factors played roles as well.

November 3, 2016 8:00 am

More Children Are Being Poisoned By Prescription Opioids (NPR)

Young children and teenagers are increasingly likely to be poisoned by opioid painkillers that are often prescribed for other family members, a study finds.

November 2, 2016 8:00 am

Male Birth Control Injections Found Effective, But Study Cut Short Due to Side-Effects (US News)

New research published Thursday in The Journal of Clinical Endocrinology & Metabolismshows hormonal birth control injections for men could be effective. But don’t expect to see them on the market anytime soon. The study was cut short due to side effects including depression, mood changes and libido issues – in short, side effects similar to those experienced by women who take hormone-based birth control.

October 28, 2016 8:00 am

Big pharma is gearing up to defend drug prices (Washington Post)

The skyrocketing costs of prescription drugs has been noticeably absent from discussion in the presidential debates — even as bipartisan anger about price gouging has united Congress. But the trade group for the pharmaceutical industry, PhRMA, is gearing up to defend drug prices after the election, seeking an additional $100 million in annual dues from its members, according to a report from Politico.

October 27, 2016 8:00 am

How drugs intended for patients ended up in the hands of illegal users: ‘No one was doing their job’ (Washington Post)

For 10 years, the government waged a behind-the-scenes war against pharmaceutical companies that hardly anyone knows: wholesale distributors of prescription narcotics that ship drugs from manufacturers to consumers.

October 26, 2016 8:00 am

Cardiac Patient Aided by Bystanders Who Were Alerted by App (NPR)

If your heart is going to stop, right outside a hospital is not a bad place for it. And if 41 people within a 330-yard radius have a cellphone app alerting them to your distress, so much the better.

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