Hot Topics: Health Care

Blog Posts (2146)

July 29, 2015

Reasonable Regulation of Surrogate Motherhood

Bonnie Steinbock
July 29, 2015

Voyage of Life [EOL in Art 79]

Thomas Cole painted "The Voyage of Life" in 1842.  The four paintings represent the stages of human life: childhood, youth, manhood, and old age. The paintings follow a voyager who travels in a boat on a river, the river of life.  The landsc...
July 29, 2015

International Symposium on Brain Death & Disorders of Consciousness

The Seventh International Symposium on Brain Death and Disorders of Consciousness will be held this December in Havana, Cuba.


















SUBMIT AN ABSTRACT
You can participate in the Symposium as a delegate, although the conference organizers encourage you to submit an abstract.  Deadline for submission of abstracts: September 15, 2015.  Notification of Accepted Abstracts: October 15, 2015.

MAIN TOPICS:  BRAIN DEATH
  • Conceptual approach to human death.
  • BD criteria in different countries.
  • Ancillary tests in BD.
  • Autonomic nervous system assessment in BD.
  • BD in childhood.
  • Anencephalic infants.
  • End-of-life dilemmas: terminal patient, euthanasia, assisted suicide, etc.
  • Legal considerations surrounding BD and related states.
  • Philosophical, theological, sociological, historical and cultural considerations of human death.
  • Organ transplantation.

MAIN TOPICS:  DISORDERS OF CONSCIOUSNESS
  • Pathophysiological mechanisms of consciousness generation.
  • Coma, persistent vegetative state (PVS), minimally conscious state (MCS), and other DOC.
  • Clinical diagnosis of DOC.
  • Neuroimaging techniques for assessing DOC.
  • Neurophysiologic tests for assessing DOC.
  • Autonomic nervous system assessment of DOC.
  • Neurorehabilitation of DOC.
  • Neuroprotection and Neuromonitoring of DOC.
  • New trends in cardio-pulmonar-cerebral resuscitation.

AMERICAN CITIZENS CAN LEGALLY ATTEND
After the announcement of the re-establishment of USA and Cuba diplomatic relationships, US citizens DO NOT require requesting special permissions to attend a meeting in Cuba, because they can attend any conference in Cuba that relates to the traveler’s profession, professional background, or area of expertise, including graduate-level full-time study.

GENERAL DESCRIPTION
Although inserted into a worldwide debate, the acceptance that a human being with irreversible loss of brain functions is dead has been progressively accepted beginning as far back as the late 1950’s. Nonetheless, two contentious brain-dead cases have recently raised again new controversies about the diagnosis of brain death (BD), widely covered by the US and international press. 

The Jahi McMath case centers on the bioethical debate surrounding her family s rejection for accepting the BD diagnosis, and their efforts to maintain her body on mechanical ventilation. 

Marlise Nicole Muñoz was declared brain-dead, but, doctors kept her body on a respirator  because she was 14 weeks pregnant. Contrary to the McMath case, Muñoz s husband entered a legal battle to have her removed from life support, assuring that she had previously told him that in case of BD, she would not want to be kept alive artificially.  Moreover, Erick Muñoz s attorneys also argued that the fetus had suffered from oxygen deprivation and was suspected to be non-viable.

Furthermore, the Terri Schiavo, and other famous cases have raised new controversies about the diagnosis and management of the persistent vegetative, the minimally conscious state, etc. Hence, the disorders of consciousness discussions are actual and permanent subjects for debate in the media and scientific discussion in any forum.

July 28, 2015

Jahi McMath - Court May Allow Family to Prove She is Now Alive

This Thursday at 2:00, in Department 20 of the Alameda County Superior Court, Judge Freedman will hold a hearing on the medical defendants' demurrer to the medical malpractice complaint by the family of Jahi McMath.   The focus of the hearing wil...
July 28, 2015

A Friendly Reminder [EOL in Art 78]

I was delighted to see Bert Rodrguez's 2005 "A Friendly Reminder" at the Boca Raton Museum of Art this week.
July 27, 2015

Medicare’s Proposed Rule Is Just the First Step

<p style="font-size: 11.1999998092651px; line-height: 19.0400009155273px;"><span style="font-size: 11.1999998092651px; line-height: 19.0400009155273px;">As Jane Jankowski, DPS, LMSW discussed in her <a href="/BioethicsBlog/post.cfm/medicare-considers-the-value-of-advance-care-planning">last AMBI blog</a> posted on June 16, 2015, the proposed rule to reimburse providers for conversations with patients about advance care planning takes a positive step toward educating patients on end-of-life medical considerations by incentivizing doctors to take the time to address these issues in the clinical setting.  Assuming that such reimbursements depend only on raising the topic of advance care planning with patients and not on the content of a patient’s choices (such as whether or not a patient chooses to forego treatment), encouraging health care providers to discuss health care decision making in advance with patients can go a long way to support patient autonomy and provide helpful guidance to surrogate decision-makers when a patient lacks capacity.  Doctors often cite lack of time as a reason why they do not address advance directives in the clinical setting, but this rule would compensate doctors for their time, allowing them more flexibility in allocating time to address these issues.  However, the proposed rule does nothing to ensure that the providers having these conversations are equipped with the proper tools and training to do so.</span></p> <p style="font-size: 11.1999998092651px; line-height: 19.0400009155273px;"><span style="font-size: 11.1999998092651px; line-height: 19.0400009155273px;">Advance directives, although they address the provision of medical treatments, are legal documents that can be complex and far-reaching, and therefore are not necessarily self-explanatory to patients or providers.  Many states offer a statutory form advance directive as an example, but all too often these forms may be merely printed by a provider and given to patients to sign without sufficient explanation.  These forms vary in their scope, but some sample living wills, such as forms from </span><a style="font-size: 11.1999998092651px; line-height: 19.0400009155273px;" href="http://www.legis.state.wv.us/WVCODE/Code.cfm?chap=16&amp;art=30#30">West Virginia</a><span style="font-size: 11.1999998092651px; line-height: 19.0400009155273px;"> and </span><a style="font-size: 11.1999998092651px; line-height: 19.0400009155273px;" href="http://aging.sc.gov/SiteCollectionDocuments/L/LivingWill2014.pdf">South Carolina</a><span style="font-size: 11.1999998092651px; line-height: 19.0400009155273px;">, are little more than a declaration that no life-sustaining treatments should be provided.  Other states, such as</span><a style="font-size: 11.1999998092651px; line-height: 19.0400009155273px;" href="http://www.michiganlegalaid.org/library_client/resource.2006-07-27.3541829543/html_view">Michigan </a><span style="font-size: 11.1999998092651px; line-height: 19.0400009155273px;">and </span><a style="font-size: 11.1999998092651px; line-height: 19.0400009155273px;" href="http://www.massmed.org/Patient-Care/Health-Topics/Health-Care-Proxies-and-End-of-Life-Care/Important-Differences-Between-Health-Care-Proxies-and-Living-Wills/">Massachusetts</a><span style="font-size: 11.1999998092651px; line-height: 19.0400009155273px;">, have no law giving legal recognition to living wills at all.  It is possible that patients may be given forms such as these and not understand that they have the option to declare that they wish to receive particular life-sustaining treatments if they are terminally ill.  It is also possible that patients who do not want to limit treatment will decline to sign any advance directive at all, believing that such documents serve only to support a decision to forego treatment at the end of life, and not a decision to receive some or all interventions.  In such situations, merely starting the conversation may not be enough to help patients effectively articulate their wishes, whatever those wishes may be.</span></p> <p><span style="color: #34405b; font-family: Arial, Helvetica, sans-serif; line-height: 19.0400009155273px; font-size: 12px;"><strong>The Alden March Bioethics Institute offers a Master of Science in Bioethics, a</strong> </span><strong style="color: #34405b; font-family: Arial, Helvetica, sans-serif; line-height: 19.0400009155273px; font-size: 12px;">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="/Academic/bioethics/index.cfm">website</a>.</strong></p>
July 27, 2015

Update: The Growing Need for a Systematic Approach to Compensation for Research-Related Injuries

(This post also appears on the Penn Wharton Public Policy Initiative) In December 2011, the Presidential Commission for the Study of Bioethical Issues (the Bioethics Commission) released its report Moral Science: Protecting Participants in Human Subjects Research. In it, the Commission responded to a charge from the President to determine if federal regulations and international […]
July 27, 2015

More California Brain Death Disputes

In addition to the Jahi Mcath case, I was recently blogged about a few other brain death disputes in California.   Johah Panduro Lisa Avila I discussed a few other CA cases in this talk in Los Angeles Last week, there was yet another court cas...
July 27, 2015

Illness & Healing: Images of Cancer [EOL in Art 77]

Robert Pope (no relation) published this 140-page volume in 1995.  The 92 illustrations evoke the dependence, fear, loneliness, pain, and even the mutilation surrounding cancer illness and therapy. These disturbing, unhappy images are difficult f...
July 26, 2015

Atul Gawande’s Look at Mortality, Part 2

I was invited to write a review of the book, Being Mortal, by Atul Gawande recently. While not a Christian book, it addresses end of life issues of interest to all involved with bioethics. This is the second half of the review, the first of which can be found here. Nearly half of Gawande’s book reflects on final things, on letting go of life in... // Read More »