Hot Topics: Health Care

Blog Posts (1285)

October 30, 2014

Advance Care Planning Tools That Educate, Engage, and Empower

In the current issue of Public Policy & Aging Report, Charlie Sabatino, American Bar Association Commission on Law and Aging, has contributed "Advance Care Planning Tools That Educate, Engage, and Empower."

Sabatino reviews a variety of pathways, tools, workbooks, and decision aids have been emerging to facilitate advance care planning and to enable documentation of one’s goals and wishes. He focuses on tools that actively engage users or at least lead users through questions that result in a work product.

The issue also includes several articles on the Campaign to End Unwanted Medical Treatment.

October 30, 2014

Minnesota Network of Hospice and Palliative Care - 2015 Conference

The Minnesota Network of Hospice and Palliative Care (MNHPC) is the state's leading hospice and palliative care network. It brings together providers, business partners, individuals and donors to increase knowledge, access services, and strengthen adv...
October 29, 2014

Quarantine: The politics are as real as the science

<p class="MsoNormal" style="line-height: 19.0400009155273px;"><span style="line-height: 19.0400009155273px;">Implementation of medical quarantines in America brings into conflict various legitimate arguments regarding who, if anyone, should have the authority to restrict movements of citizens.</span><span style="line-height: 19.0400009155273px;">  </span><span style="line-height: 19.0400009155273px;">Quarantines are not new, but they exist now in a world with new dangers and new opportunities for abuse.</span></p> <p class="MsoNormal" style="line-height: 19.0400009155273px;"><span style="line-height: 19.0400009155273px;">In teaching medical students in recent years, it became apparent that many students found the concept of a home quarantine to be abhorrent.</span><span style="line-height: 19.0400009155273px;">  </span><span style="line-height: 19.0400009155273px;">Many were aghast at the concept that a patient could be restricted from daily activities, and found it an egregious violation of civil liberties and ethical conduct.</span><span style="line-height: 19.0400009155273px;">  </span><span style="line-height: 19.0400009155273px;">Interestingly, these views were often </span><span style="line-height: 19.0400009155273px; text-decoration: underline;">not</span><span style="line-height: 19.0400009155273px;"> mitigated substantially when students were informed that, in former days, quarantines were fairly common in this country and elsewhere.</span><span style="line-height: 19.0400009155273px;">  </span><span style="line-height: 19.0400009155273px;">In a world before the Internet in which home confinement was really quite restrictive, medical quarantines for diseases such as small pox, tuberculosis, or even measles were not uncommon.</span><span style="line-height: 19.0400009155273px;"> </span><span style="line-height: 19.0400009155273px;">Such quarantines were usually imposed by a local health official.</span><span style="line-height: 19.0400009155273px;">  </span><span style="line-height: 19.0400009155273px;">In addition, many families self-quarantined, or at least avoided exposure to potential sources of disease.</span><span style="line-height: 19.0400009155273px;"> </span><span style="line-height: 19.0400009155273px;">For example, some people used to avoid many summer activities for fear of contracting polio.</span><span style="line-height: 19.0400009155273px;">  </span><span style="line-height: 19.0400009155273px;">Due largely to the development of vaccination, many of the diseases that would have invoked a quarantine in earlier years are no longer of concern, and the concept of quarantine has become a bit anachronistic, even in a world that offers many portals that would seemingly make confinement less onerous.</span><span style="line-height: 19.0400009155273px;">  </span><span style="line-height: 19.0400009155273px;">But the topic of quarantine requires renewed consideration in the world of today.</span></p> <p class="MsoNormal" style="line-height: 19.0400009155273px;"><strong style="line-height: 19.0400009155273px; color: #34405b; font-family: Arial, Helvetica, sans-serif; font-size: 12px;">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="text-decoration: underline; color: #000099;" href="http://www.amc.edu/Academic/bioethics/index.cfm">website</a>.</strong></p>
October 29, 2014

How Medicare Is Punishing Hospitals That Care For Poor People

Such a no-brainer: If patients who receive care at Hospital A are more likely to get readmitted to the hospital 10, 20 or 30 days after discharge than patients in Hospital B, then Hospital A must be doing something wrong. … Continue reading
October 29, 2014

Ebola and Human Nature

With over half of the posts on this blog in the past 2 weeks being about Ebola I was hesitant to write more about it, but I will anyway. In the midst of daily e-mails from the hospital system I work for about mandatory Ebola screening training and containment procedures and questions from the students where I teach it is hard to avoid thinking about... // Read More »
October 29, 2014

Jahi McMath - Prematurely Fostering Mistrust

Jahi McMath was adjudicated as legally dead in December 2013.  Her family has yet to deliver any cogent, definitive evidence that supports changing her diagnosis. Can they?  Will they? If Jahi's family can establish (with independent expert ...
October 28, 2014

If no travel restrictions, then….quarantine?

As the Ebola epidemic rages on, the debate about travel limitations has moved inevitably to the next stage: whether there ought to be a quarantine imposed on healthcare providers and others returning from service in endemic areas. We have been reading two opposing views, one emphasizing, as did Governor Christie of New Jersey, that “the obligation of elected officials is to protect the public health... // Read More »
October 28, 2014

Responding to Ebola: The Question of Quarantine

Karyn L. Boyar
October 28, 2014

More Secret DNR Orders in UK - Barbara Gibson

In the UK, clinicians may write a DNR order without consent, if they deem that to be in the patient's best interest.  But clinicians must still consult with the patient or family.  In other words, they may write a unilateral DNR order.  But they may not write a "secret" DNR order.
 
Yet, as I have recounted on this blog more than a dozen times, this continues to happen.   One of the most recent cases occurred in August 2014 at Ayr Hospital.

In an apology letter to the family, the said: “I wish to offer my sincere apologies again on behalf of all the staff concerned for the distressing events you have described, and wish to reassure you that lessons have been learned and that practice around DNACPR decisions are being reviewed and improved as a matter of urgency across the organization. . . .  It is evident from the review of Mrs Gibson’s medical records, and discussions with staff involved, there were failures in communicating the medical decisions around resuscitation to Mrs Gibson and yourselves.”




October 27, 2014

Bioethics Commission FAQs from ASBH

Last week the Presidential Commission for the Study of Bioethical Issues (Bioethics Commission) attended the American Society for Bioethics and Humanities (ASBH) annual meeting, held in San Diego, California October 16-19. Along with leading multiple presentations, the Bioethics Commission was pleased to host a booth in the conference’s exhibition hall. The exhibit featured Commission reports […]