Bioethics.net » Health Care http://www.bioethics.net Where the World Finds Bioethics Sat, 23 May 2015 09:00:01 +0000 en-US hourly 1 http://wordpress.org/?v=4.0.1 Jahi McMath – Status in May 2015 http://feedproxy.google.com/~r/MedicalFutilityBlog/~3/8w_UzyL-G3M/jahi-mcmath-status-in-may-2015.html http://feedproxy.google.com/~r/MedicalFutilityBlog/~3/8w_UzyL-G3M/jahi-mcmath-status-in-may-2015.html#comments Sat, 23 May 2015 09:00:00 +0000 http://www.bioethics.net/?guid=002e92c2f95474df549dbe8ff759aeba http://medicalfutility.blogspot.com/feeds/4831490549768685450/comments/default 0 Victor Hugo on His Deathbed [EOL in Art 13] http://feedproxy.google.com/~r/MedicalFutilityBlog/~3/m1ZXw2bQ6NQ/victor-hugo-on-his-deathbed-eol-in-art.html http://feedproxy.google.com/~r/MedicalFutilityBlog/~3/m1ZXw2bQ6NQ/victor-hugo-on-his-deathbed-eol-in-art.html#comments Sat, 23 May 2015 09:00:00 +0000 http://www.bioethics.net/?guid=3e53bc6fd46219c562aa77ce4fb97d44 http://medicalfutility.blogspot.com/feeds/2144419531336783658/comments/default 0 Absence of POLST Leads to Criminal Charges http://feedproxy.google.com/~r/MedicalFutilityBlog/~3/cP7Obk3C38E/absence-of-polst-leads-to-criminal.html http://feedproxy.google.com/~r/MedicalFutilityBlog/~3/cP7Obk3C38E/absence-of-polst-leads-to-criminal.html#comments Sat, 23 May 2015 02:32:00 +0000 http://www.bioethics.net/?guid=33433a3741f9759133fd185492d1f62f http://medicalfutility.blogspot.com/feeds/1250219880094065005/comments/default 0 The Question Isn’t Whether We Are Overdiagnosing Cancer, But How Much http://www.peterubel.com/mdm/question-isnt-whether-overdiagnosing-cancer-much/ http://www.peterubel.com/mdm/question-isnt-whether-overdiagnosing-cancer-much/#comments Fri, 22 May 2015 14:19:25 +0000 http://www.peterubel.com/?p=7469 Medical experts now agree that as a result of aggressive screening programs, we have an epidemic of cancer overdiagnosis in the United States. With mammograms finding tiny cancers and PSA tests discovering unpalpable prostate cancers, we are now unearthing some … Continue reading

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Dying without Dignity – Investigations by the Parliamentary and Health Service Ombudsman into Complaints about End of Life Care http://feedproxy.google.com/~r/MedicalFutilityBlog/~3/V626v45gR7o/dying-without-dignity-investigations-by.html http://feedproxy.google.com/~r/MedicalFutilityBlog/~3/V626v45gR7o/dying-without-dignity-investigations-by.html#comments Fri, 22 May 2015 11:47:00 +0000 http://www.bioethics.net/?guid=bd88213008dda0386a2adae070792ece The UK Parliamentary and Health Service Ombudsman has just published an alarming report on the end of life care, “Dying Without Dignity.”  It is a painful and sad read.

The report identifies six key themes, all illustrated with case studies
  1. Not recognising that people are dying, and not responding to their needs – if the needs of those who are close to death are not recognised, their care cannot be planned or co‐ordinated, which means more crises and distress for the person and their family and carers.
  2. Poor symptom control – people have watched their loved ones dying in pain or in an agitated state because their symptoms have been ineffectively or poorly managed.
  3. Poor communication – poor communication is an important element in our complaints on end of life care. It is clear that healthcare professionals do not always have the open and honest conversations with family members and carers that are necessary for them to understand the severity of the situation, and the subsequent choices they will have to make.
  4. Inadequate out‐of‐hours services – people who are dying and their carers suffer because of the difficulties in getting palliative care outside normal working hours.
  5. Poor care planning – a failure to plan adequately often leads to the lack of co‐ordinated care, for example, GPs and hospitals can fail to liaise.
  6. Delays in diagnosis and referrals for treatment – this can mean that people are denied the chance to plan for the end of their life and for their final wishes to be met.

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Marcel Proust on His Deathbed [EOL in Art 12] http://feedproxy.google.com/~r/MedicalFutilityBlog/~3/4Vn2hTD72r8/marcel-proust-on-his-deathbed-eol-in.html http://feedproxy.google.com/~r/MedicalFutilityBlog/~3/4Vn2hTD72r8/marcel-proust-on-his-deathbed-eol-in.html#comments Fri, 22 May 2015 09:30:00 +0000 http://www.bioethics.net/?guid=b64b969a8573d7b34530143eabda4a18 http://medicalfutility.blogspot.com/feeds/6264580035373032171/comments/default 0 Conscience and Proper Medical Treatment http://feedproxy.google.com/~r/MedicalFutilityBlog/~3/zNBpsrVXdQ4/conscience-and-proper-medical-treatment.html http://feedproxy.google.com/~r/MedicalFutilityBlog/~3/zNBpsrVXdQ4/conscience-and-proper-medical-treatment.html#comments Fri, 22 May 2015 00:21:00 +0000 http://www.bioethics.net/?guid=0fb8cc665325abab6d630023c01bc2f1 http://medicalfutility.blogspot.com/feeds/4480790157688365959/comments/default 0 Don’t Be Afraid to Team Up with Your Doctor about Healthcare Costs http://www.peterubel.com/uncategorized/dont-afraid-team-doctor-healthcare-costs/ http://www.peterubel.com/uncategorized/dont-afraid-team-doctor-healthcare-costs/#comments Thu, 21 May 2015 12:24:06 +0000 http://www.peterubel.com/?p=7465 Here is a fine story in the Los Angeles Times written by Lisa Zamosky about the importance of talking with your doctor about your out of pocket medical costs. Despite high medical costs topping Americans’ list of financial concerns, many … Continue reading

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Terminally Ill Patients Visit the Museum [EOL in Art 11] http://feedproxy.google.com/~r/MedicalFutilityBlog/~3/8JLM-gA-THw/terminally-ill-patients-visit-museum.html http://feedproxy.google.com/~r/MedicalFutilityBlog/~3/8JLM-gA-THw/terminally-ill-patients-visit-museum.html#comments Thu, 21 May 2015 09:30:00 +0000 http://www.bioethics.net/?guid=11e7b714ba3eab7f81c19bc354ffdd6d http://medicalfutility.blogspot.com/feeds/4138455678466061671/comments/default 0 Aid in Dying: An Important Possibility at the End of Life http://feedproxy.google.com/~r/MedicalFutilityBlog/~3/uXWlc8kKg1k/aid-in-dying-important-possibility-at.html http://feedproxy.google.com/~r/MedicalFutilityBlog/~3/uXWlc8kKg1k/aid-in-dying-important-possibility-at.html#comments Thu, 21 May 2015 09:00:00 +0000 http://www.bioethics.net/?guid=586dbe590050b61dd12d354a528258ea http://medicalfutility.blogspot.com/feeds/8113628743341095301/comments/default 0 These Americans Are Rich – Should We Celebrate? http://www.peterubel.com/uncategorized/americans-rich-celebrate/ http://www.peterubel.com/uncategorized/americans-rich-celebrate/#comments Wed, 20 May 2015 20:55:29 +0000 http://www.peterubel.com/?p=7462 American manufacturing has declined precipitously in the past few decades. Companies that were once the source of fabulous wealth for Americans – the U.S. Steel profits that enriched the Carnegie family, the Ford Motor F -1.29% Company profits that enriched … Continue reading

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Grief and Mourning at Death [EOL in Art 10] http://feedproxy.google.com/~r/MedicalFutilityBlog/~3/4ASEKiezHsI/grief-and-mourning-at-death-eol-in-art.html http://feedproxy.google.com/~r/MedicalFutilityBlog/~3/4ASEKiezHsI/grief-and-mourning-at-death-eol-in-art.html#comments Wed, 20 May 2015 09:00:00 +0000 http://www.bioethics.net/?guid=a966c00b7a0f75d9f8f217b8f8746f62 http://medicalfutility.blogspot.com/feeds/419760434390689864/comments/default 0 Physicians Should Not Act Like Judges (video) http://feedproxy.google.com/~r/MedicalFutilityBlog/~3/6-dfOO1Xt3g/physicians-should-not-act-like-judges.html http://feedproxy.google.com/~r/MedicalFutilityBlog/~3/6-dfOO1Xt3g/physicians-should-not-act-like-judges.html#comments Wed, 20 May 2015 08:30:00 +0000 http://www.bioethics.net/?guid=6d0acac79baf202c39b0fa8078832726 http://medicalfutility.blogspot.com/feeds/6031181433489649444/comments/default 0 New Educational Module from the Bioethics Commission on Informed Consent in Neuroscience Now Available http://blog.bioethics.gov/2015/05/19/new-educational-module-from-the-bioethics-commission-on-informed-consent-in-neuroscience-now-available/ http://blog.bioethics.gov/2015/05/19/new-educational-module-from-the-bioethics-commission-on-informed-consent-in-neuroscience-now-available/#comments Tue, 19 May 2015 15:55:08 +0000 http://blog.bioethics.gov/?p=1629 http://blog.bioethics.gov/2015/05/19/new-educational-module-from-the-bioethics-commission-on-informed-consent-in-neuroscience-now-available/feed/ 0 Aruna Shanbaug Dies after 42 Years in PVS http://feedproxy.google.com/~r/MedicalFutilityBlog/~3/Gt1dWl3letE/aruna-shanbaug-dies-after-42-years-in.html http://feedproxy.google.com/~r/MedicalFutilityBlog/~3/Gt1dWl3letE/aruna-shanbaug-dies-after-42-years-in.html#comments Tue, 19 May 2015 15:37:00 +0000 http://www.bioethics.net/?guid=3370980331e356d0c80c4142f2e56a80 Aruna Shanbaug has died in Mumbai after spending 42 years in a vegetative state.

Shanbaug suffered brain damage from a sexual assault and strangling in 1973 by a cleaner at the hospital where she worked. She remained in a vegetative state in Mumbai’s King Edward Memorial Hospital until her death this week.  (Wall Street Journal)


In 2011, the Supreme Court considered Shanbaug’s case after her biographer and friend, Pinki Virani, filed a petition asking judges to order the hospital to stop feeding her and “allow her to die peacefully.”  But, as I wrote at the time, the court denied Virani's petition.


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Monet and Camille [EOL in Art 9] http://feedproxy.google.com/~r/MedicalFutilityBlog/~3/AqswZciddXs/monet-and-camille-eol-in-art-9.html http://feedproxy.google.com/~r/MedicalFutilityBlog/~3/AqswZciddXs/monet-and-camille-eol-in-art-9.html#comments Tue, 19 May 2015 09:00:00 +0000 http://www.bioethics.net/?guid=b970c3b8064b2a70f2ba161112e0e3cb Monet lived to 86.  But his wife Camille Doncieux died at just 32.

“Camille Monet sur son lit de mort,” or “Camille on Her Deathbed” (1879) is one of Monet’s most powerful paintings of his wife.


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Monet and Camille [EOL in Art 9] http://feedproxy.google.com/~r/MedicalFutilityBlog/~3/AqswZciddXs/monet-and-camille-eol-in-art-9.html http://feedproxy.google.com/~r/MedicalFutilityBlog/~3/AqswZciddXs/monet-and-camille-eol-in-art-9.html#comments Tue, 19 May 2015 09:00:00 +0000 http://www.bioethics.net/?guid=b970c3b8064b2a70f2ba161112e0e3cb Monet lived to 86.  But his wife Camille Doncieux died at just 32.

“Camille Monet sur son lit de mort,” or “Camille on Her Deathbed” (1879) is one of Monet’s most powerful paintings of his wife.


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Should someone who does not want biological children be diagnosed as infertile? http://www.amc.edu/BioethicsBlog/post.cfm/should-someone-who-does-not-want-biological-children-be-diagnosed-as-infertile http://www.amc.edu/BioethicsBlog/post.cfm/should-someone-who-does-not-want-biological-children-be-diagnosed-as-infertile#comments Tue, 19 May 2015 08:05:43 +0000 http://www.bioethics.net/?guid=7fc63eac2778d75e36b30cfcbd59c73d http://www.bioethics.net/2015/05/should-someone-who-does-not-want-biological-children-be-diagnosed-as-infertile/feed/ 0 Whispering of Death [EOL in Art 8] http://feedproxy.google.com/~r/MedicalFutilityBlog/~3/GpKdT6YO95M/whispering-of-death-eol-in-art-8.html http://feedproxy.google.com/~r/MedicalFutilityBlog/~3/GpKdT6YO95M/whispering-of-death-eol-in-art-8.html#comments Mon, 18 May 2015 09:00:00 +0000 http://www.bioethics.net/?guid=953b192f3bea0a0c47623c69d771d06d Arnold Böcklin painted this self-portrait in 1872.  Since there seems to be only one string left on the violin, it seems that death is whispering, "I'm coming for you soon."


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Texas House Votes to Narrow Futility Law http://feedproxy.google.com/~r/MedicalFutilityBlog/~3/RWOaP8kYzls/texas-house-votes-to-narrow-futility-law.html http://feedproxy.google.com/~r/MedicalFutilityBlog/~3/RWOaP8kYzls/texas-house-votes-to-narrow-futility-law.html#comments Mon, 18 May 2015 08:00:00 +0000 http://www.bioethics.net/?guid=5f91ae9322df6901317ef19aa9b3ec4a http://medicalfutility.blogspot.com/feeds/8871740938658865206/comments/default 0 History of Cardiac Arrest and Its Effect on Contemporary Medicine (video) http://feedproxy.google.com/~r/MedicalFutilityBlog/~3/NusncN_24Is/history-of-cardiac-arrest-and-its.html http://feedproxy.google.com/~r/MedicalFutilityBlog/~3/NusncN_24Is/history-of-cardiac-arrest-and-its.html#comments Sun, 17 May 2015 09:30:00 +0000 http://www.bioethics.net/?guid=f0cd8d9fb677b0ab7341190b89d8fe52 http://medicalfutility.blogspot.com/feeds/3452829734024384998/comments/default 0 Death Will Come for You [EOL in Art 7] http://feedproxy.google.com/~r/MedicalFutilityBlog/~3/4ZWF_9cIhuI/death-will-come-for-you-eol-in-art-7.html http://feedproxy.google.com/~r/MedicalFutilityBlog/~3/4ZWF_9cIhuI/death-will-come-for-you-eol-in-art-7.html#comments Sun, 17 May 2015 09:00:00 +0000 http://www.bioethics.net/?guid=7b6ac7ecc4f86a3e2146630806bce33f http://medicalfutility.blogspot.com/feeds/1601718877303913637/comments/default 0 Minnesota Case: Final Exit Network Found Guilty of a Crime for Mere Speech http://feedproxy.google.com/~r/MedicalFutilityBlog/~3/_ZNr30bpq9A/minnesota-case-final-exit-network-found.html http://feedproxy.google.com/~r/MedicalFutilityBlog/~3/_ZNr30bpq9A/minnesota-case-final-exit-network-found.html#comments Sat, 16 May 2015 22:40:00 +0000 http://www.bioethics.net/?guid=7c4baf81cfe85fce9f7a8543addd81d2 http://medicalfutility.blogspot.com/feeds/5518823035650889684/comments/default 0 An Official ATS/AACN/ACCP/ESICM/SCCM Policy Statement: Responding to Requests for Potentially Inappropriate Treatments in Intensive Care Unit http://feedproxy.google.com/~r/MedicalFutilityBlog/~3/rLZuUaBPQs0/an-official-atsaacnaccpesicmsccm-policy.html http://feedproxy.google.com/~r/MedicalFutilityBlog/~3/rLZuUaBPQs0/an-official-atsaacnaccpesicmsccm-policy.html#comments Sat, 16 May 2015 15:26:00 +0000 http://www.bioethics.net/?guid=cc341c532d6c8118a4bc51c79b20ac23 Almost all of the major professional association guidelines on medical futility are more than a decade old.  Finally, a new multi-society policy was published online yesterday.  I was pleased to be a part of it.

There is controversy about how to manage requests by patients or surrogates for treatments that clinicians believe should not be administered.  This multi-society statement provides recommendations to prevent and manage intractable disagreements about the use of such treatments in intensive care units. 


The recommendations were developed using an iterative consensus process, including expert committee development and peer review by designated committees of each of the participating professional societies (American Thoracic Society, American Association for Critical Care Nurses, American College of Chest Physicians, European Society for Intensive Care Medicine, and Society of Critical Care). 


The committee recommends: 

  • Institutions should implement strategies to prevent intractable treatment conflicts, including proactive communication and early involvement of expert consultants. 
  • The term “potentially inappropriate” should be used, rather than futile, to describe treatments that have at least some chance of accomplishing the effect sought by the patient, but clinicians believe that competing ethical considerations justify not providing them.
  • Clinicians should explain and advocate for the treatment plan they believe is appropriate. 
  • Conflicts regarding potentially inappropriate treatments that remain intractable despite intensive communication and negotiation should be managed by a fair process of conflict resolution; this process should include hospital review, attempts to find a willing provider at another institution, and opportunity for external review of decisions.

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Ignoring the Approach of Death [EOL in Art 6] http://feedproxy.google.com/~r/MedicalFutilityBlog/~3/y2CpaU3ZR9k/ignoring-approach-of-death-eol-in-art-6.html http://feedproxy.google.com/~r/MedicalFutilityBlog/~3/y2CpaU3ZR9k/ignoring-approach-of-death-eol-in-art-6.html#comments Sat, 16 May 2015 08:00:00 +0000 http://www.bioethics.net/?guid=55718ac333d73e3d8a02de59cb999056 http://medicalfutility.blogspot.com/feeds/3664655086521636485/comments/default 0 Baby Samuel – Court Vacates DNR over Mom’s Objections http://feedproxy.google.com/~r/MedicalFutilityBlog/~3/UGbuKg_wEZc/baby-samuel-dnr-over-moms-objectios.html http://feedproxy.google.com/~r/MedicalFutilityBlog/~3/UGbuKg_wEZc/baby-samuel-dnr-over-moms-objectios.html#comments Fri, 15 May 2015 23:15:00 +0000 http://www.bioethics.net/?guid=79dc85725e0cbf952a6a1578a7456e39 In January, when Samuel Flaherty Irvin was less than a month old, the Arizona Department of Child Safety took him from his mother Fawn Flaherty due to  "child abuse, neglect."  (KVOA)

Samuel was placed in a foster home for the medically fragile.  But later that month he choked when they were feeding him and went without oxygen for a prolonged period.  Samuel's treating clinician recommended that he “not receive resuscitation efforts if he deteriorates.”  So, DCS got a Tuscon Judge to authorize a “do not resuscitate” order.   

But Fawn's parental rights had not been terminated.  So, consistent with the law in other states, at the end of April, an appellate court vacated the “do not resuscitate” order.

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Last Portrait of Mother [EOL in Art 5] http://feedproxy.google.com/~r/MedicalFutilityBlog/~3/IRpAS31XvK4/last-portrait-of-mother-eol-in-art-5.html http://feedproxy.google.com/~r/MedicalFutilityBlog/~3/IRpAS31XvK4/last-portrait-of-mother-eol-in-art-5.html#comments Fri, 15 May 2015 08:00:00 +0000 http://www.bioethics.net/?guid=927702803a3c505ceb111558068f1b77 http://medicalfutility.blogspot.com/feeds/4303760083248401257/comments/default 0 Engaging Parents and Children Throughout Pediatric Research: A New Report from the Nuffield Council on Bioethics http://blog.bioethics.gov/2015/05/14/engaging-parents-and-children-throughout-pediatric-research-a-new-report-from-the-nuffield-council-on-bioethics/ http://blog.bioethics.gov/2015/05/14/engaging-parents-and-children-throughout-pediatric-research-a-new-report-from-the-nuffield-council-on-bioethics/#comments Thu, 14 May 2015 15:11:58 +0000 http://blog.bioethics.gov/?p=1627 http://blog.bioethics.gov/2015/05/14/engaging-parents-and-children-throughout-pediatric-research-a-new-report-from-the-nuffield-council-on-bioethics/feed/ 0 What Physicians Could Learn from Accountants and Veterinarians http://www.peterubel.com/uncategorized/physicians-learn-accountants-veterinarians/ http://www.peterubel.com/uncategorized/physicians-learn-accountants-veterinarians/#comments Thu, 14 May 2015 13:22:08 +0000 http://www.peterubel.com/?p=7458 Rebecca Plevin, from KPCC public radio in California, is quickly becoming one of my favorite health reporters. She is really digging in to the strange world of health economics. Here’s a nice piece she did, comparing how people talk about … Continue reading

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Assisted Suicide: Death with Dignity or Legalized Killing http://feedproxy.google.com/~r/MedicalFutilityBlog/~3/XGBiFmtM79Q/assisted-suicide-death-with-dignity-or.html http://feedproxy.google.com/~r/MedicalFutilityBlog/~3/XGBiFmtM79Q/assisted-suicide-death-with-dignity-or.html#comments Thu, 14 May 2015 12:36:00 +0000 http://www.bioethics.net/?guid=71800e5dd23539ac38ff519fde762cdb http://medicalfutility.blogspot.com/feeds/498582750819916666/comments/default 0 Death Leading the Doctor [EOL in Art 4] http://feedproxy.google.com/~r/MedicalFutilityBlog/~3/yy1BnVCE9qA/death-leading-doctor-eol-in-art-4.html http://feedproxy.google.com/~r/MedicalFutilityBlog/~3/yy1BnVCE9qA/death-leading-doctor-eol-in-art-4.html#comments Thu, 14 May 2015 08:30:00 +0000 http://www.bioethics.net/?guid=dad732c9f1340a1b8c5f66b574bc9869 http://medicalfutility.blogspot.com/feeds/3964868680507593303/comments/default 0 EMS SignPost – Medical ID on a Refrigerator Magnet http://feedproxy.google.com/~r/MedicalFutilityBlog/~3/fdBSQDIT4BU/ems-signpost-medical-id-on-refrigerator.html http://feedproxy.google.com/~r/MedicalFutilityBlog/~3/fdBSQDIT4BU/ems-signpost-medical-id-on-refrigerator.html#comments Thu, 14 May 2015 08:00:00 +0000 http://www.bioethics.net/?guid=27e04f3b652cee7b2ae005d542fdd995 http://medicalfutility.blogspot.com/feeds/7534194277678232823/comments/default 0 Why Do We Over Treat Patients in the U.S.? http://www.amc.edu/BioethicsBlog/post.cfm/why-do-we-over-treat-patients-in-the-u-s http://www.amc.edu/BioethicsBlog/post.cfm/why-do-we-over-treat-patients-in-the-u-s#comments Thu, 14 May 2015 04:05:39 +0000 http://www.bioethics.net/?guid=15d968f3722a865ca772a2194c21a338 http://www.bioethics.net/2015/05/why-do-we-over-treat-patients-in-the-u-s/feed/ 0 Bioethics Commission recommends establishing clear requirements for identifying legally authorized representatives for research participation http://blog.bioethics.gov/2015/05/13/bioethics-commission-recommends-establishing-clear-requirements-for-identifying-legally-authorized-representatives-for-research-participation/ http://blog.bioethics.gov/2015/05/13/bioethics-commission-recommends-establishing-clear-requirements-for-identifying-legally-authorized-representatives-for-research-participation/#comments Wed, 13 May 2015 15:42:30 +0000 http://blog.bioethics.gov/?p=1625 http://blog.bioethics.gov/2015/05/13/bioethics-commission-recommends-establishing-clear-requirements-for-identifying-legally-authorized-representatives-for-research-participation/feed/ 0 ETHICS OF THE POLITICS OF PAIN http://practicalbioethics.blogspot.com/2015/05/ethics-of-politics-of-pain.html http://practicalbioethics.blogspot.com/2015/05/ethics-of-politics-of-pain.html#comments Wed, 13 May 2015 14:42:00 +0000 http://www.bioethics.net/?guid=afbac540ca04ed39da7764875b8a4fb9 Picking Up the Gauntlet
On May 1, the Center for Practical Bioethics hosted an ethics symposium, something they do every spring. What made this event special enough that it moved me to write about it was the topic, Healing What Hurts: The Politics of Pain.

I’m a bit of an oddball in the pain world. I am not a healthcare professional, nor am I person with chronic pain. I am not an academician or researcher; I don’t work in industry. I am someone who came in the ‘side door’ to the pain world providing services like strategic planning, meeting coordination, and program/project management to organizations like the Center. I can’t truthfully say that helping to change the way pain is perceived, judged and treated is a personal passion of mine. But it has become something I believe in and care about, a testament to the incredible people at the Center with whom I have the privilege of working, and my exposure to the thinking and work of individuals like those who presented last week.

At the symposium, I felt like I was witnessing the creation of a beautiful tapestry, with each speaker picking up the thread of those who came before and continuing to weave the threads together until the complicated (and troubling) reality of the polarizing space in which pain currently resides was achingly clear. Some threads:
  • Historian and author Dr. Keith Wailoo’s spellbinding historical dissection of the poles our policymakers and courts have swung between in answering the questions, “Whose pain matters and who deserves care?” While historians feel more comfortable looking back instead of ahead, Dr. Wailoo did offer some insight into my question of how to have success this time around in making sure that reimbursement model changes follow our ability to demonstrate that comprehensive multi-modal pain care holds down costs and improves outcomes.
  • Dr. Kathy M. Foley (I view her as the Grand Dame of this continent’s pain movement) exposing the harsh realities of care being forced to focus on what’s reimbursable vs. what’s best for the person with pain.
  • Dr. Bob Twillman laying bare the damage caused when overly simplistic policy and action around harm reduction focuses solely on cutting down on the supply of prescription narcotics, without looking at the demand side and asking, “In which patients should we use opioids, at what doses, for how long, with which adjunctive treatments, and with what precautions?”
  • Dr. Richard Payne sharing some pretty mind-blowing emerging science about how the social determinants of health most closely associated with underserved populations actually affects one’s biology. Melissa Robinson from the Black Health Care Coalition made it real for the impoverished in Kansas City.
  • And, pain pioneer Dr. Lynn Webster, pain advocate Janice Lynn Shuster, and public policy expert Katie Horton reminding us all that the lives of people in pain matter and their stories must be heard.
Having worked in this arena for over a decade, I will own that the fight to make things better for people with pain feels akin to running a marathon in five feet of mud – it’s a slow slog even on good days. The assembled audience sensed there may still be some dark days ahead before the pendulum swings back towards reason and progress. But the conviction that things will get better and that we must continue the fight was evident in abundance.

Who else but the Center could and would provide the kind of thought provoking and engaging delve into the ethics of the politics of pain? There may be others, but the Center picked up the gauntlet and ran with it. And for that, they have my love, admiration and respect. [In the spirit of full disclosure, I currently do some consulting work for the Center on the PAINS Project.]

Written By Ann J. Corley, MS

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Showing Doctors How to Lower Healthcare Costs http://www.peterubel.com/uncategorized/showing-doctors-lower-healthcare-costs/ http://www.peterubel.com/uncategorized/showing-doctors-lower-healthcare-costs/#comments Wed, 13 May 2015 13:43:11 +0000 http://www.peterubel.com/?p=7455 There are lots of things we need to do to get healthcare costs under control in the United States. Critical to most of our efforts, however, is to get physicians to practice cost-conscious care. Here is a nice story on … Continue reading

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POLST – An Authoritative Summary http://feedproxy.google.com/~r/MedicalFutilityBlog/~3/HUP0ecM6SvU/polst-authoritative-summary.html http://feedproxy.google.com/~r/MedicalFutilityBlog/~3/HUP0ecM6SvU/polst-authoritative-summary.html#comments Wed, 13 May 2015 08:30:00 +0000 http://www.bioethics.net/?guid=7a4a644024db346ff6936f00ae8a5860 http://medicalfutility.blogspot.com/feeds/5044853182882692747/comments/default 0 Overtreatment in 1848 [EOL in Art 3] http://feedproxy.google.com/~r/MedicalFutilityBlog/~3/CswjbA3f5r8/overtreatment-in-1848-eol-in-art-3.html http://feedproxy.google.com/~r/MedicalFutilityBlog/~3/CswjbA3f5r8/overtreatment-in-1848-eol-in-art-3.html#comments Wed, 13 May 2015 08:30:00 +0000 http://www.bioethics.net/?guid=cebd47faaec0d686fbf5251929694ecc http://medicalfutility.blogspot.com/feeds/8866803178495768946/comments/default 0 New Education Materials from the Bioethics Commission on Research Design Now Available http://blog.bioethics.gov/2015/05/12/new-education-materials-from-the-bioethics-commission-on-research-design-now-available/ http://blog.bioethics.gov/2015/05/12/new-education-materials-from-the-bioethics-commission-on-research-design-now-available/#comments Tue, 12 May 2015 16:40:40 +0000 http://blog.bioethics.gov/?p=1623 http://blog.bioethics.gov/2015/05/12/new-education-materials-from-the-bioethics-commission-on-research-design-now-available/feed/ 0 What Do Cancer Centers Think Patients Are Looking For? http://www.peterubel.com/uncategorized/cancer-centers-think-patients-looking/ http://www.peterubel.com/uncategorized/cancer-centers-think-patients-looking/#comments Tue, 12 May 2015 13:28:21 +0000 http://www.peterubel.com/?p=7452 If you were a cancer center trying to get patients to come to receive care at your facility, what message would you send them? In other words, what would you as a cancer center director think people would value in … Continue reading

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Respice Finem [EOL in Art 2] http://feedproxy.google.com/~r/MedicalFutilityBlog/~3/E2QL3hXquBA/respice-finem-eol-in-art-2.html http://feedproxy.google.com/~r/MedicalFutilityBlog/~3/E2QL3hXquBA/respice-finem-eol-in-art-2.html#comments Tue, 12 May 2015 09:00:00 +0000 http://www.bioethics.net/?guid=d92db131a727eee4e70b80b3e9aec757 http://medicalfutility.blogspot.com/feeds/250588229423570900/comments/default 0 Ethical Reflection in End-of-Life Decisions: Dutch Perspective (UMN) http://feedproxy.google.com/~r/MedicalFutilityBlog/~3/RbO6W2oKSQk/ethical-reflection-in-end-of-life.html http://feedproxy.google.com/~r/MedicalFutilityBlog/~3/RbO6W2oKSQk/ethical-reflection-in-end-of-life.html#comments Mon, 11 May 2015 21:58:00 +0000 http://www.bioethics.net/?guid=800367f60fbb79c8af4981eaebf05c3b http://medicalfutility.blogspot.com/feeds/4181522570038298794/comments/default 0 POLST or Advance Directive? [EOL in Art 1] http://feedproxy.google.com/~r/MedicalFutilityBlog/~3/pZW6Rx-XgJs/polst-or-advance-directive-eol-in-art-1.html http://feedproxy.google.com/~r/MedicalFutilityBlog/~3/pZW6Rx-XgJs/polst-or-advance-directive-eol-in-art-1.html#comments Mon, 11 May 2015 12:30:00 +0000 http://www.bioethics.net/?guid=4afe22b312a8039eabb71441fa995f0d http://medicalfutility.blogspot.com/feeds/1269491544279883659/comments/default 0 Social Media and Patient Information http://www.amc.edu/BioethicsBlog/post.cfm/social-media-and-patient-information http://www.amc.edu/BioethicsBlog/post.cfm/social-media-and-patient-information#comments Mon, 11 May 2015 01:05:01 +0000 http://www.bioethics.net/?guid=fb310d1964e2a3570cf691743928a263 http://www.bioethics.net/2015/05/social-media-and-patient-information/feed/ 0 Duty to Transfer Brain Dead Individual http://feedproxy.google.com/~r/MedicalFutilityBlog/~3/aHQuI_T542E/duty-to-transfer-brain-dead-individual.html http://feedproxy.google.com/~r/MedicalFutilityBlog/~3/aHQuI_T542E/duty-to-transfer-brain-dead-individual.html#comments Sat, 09 May 2015 12:18:00 +0000 http://www.bioethics.net/?guid=3a7969073a2bb13e5d4228512c35d4d8 http://medicalfutility.blogspot.com/feeds/5896368988383764066/comments/default 0 New Multi-Society Futility Policy http://feedproxy.google.com/~r/MedicalFutilityBlog/~3/PImV0Un-68A/new-multi-society-futility-policy.html http://feedproxy.google.com/~r/MedicalFutilityBlog/~3/PImV0Un-68A/new-multi-society-futility-policy.html#comments Sat, 09 May 2015 08:30:00 +0000 http://www.bioethics.net/?guid=e658e9db71d397754a1dee59edc74519 http://medicalfutility.blogspot.com/feeds/6010666621702265376/comments/default 0 Christians and Aggressive End-of-Life Care http://feedproxy.google.com/~r/MedicalFutilityBlog/~3/XjlY2Nd47v8/christians-and-aggressive-end-of-life.html http://feedproxy.google.com/~r/MedicalFutilityBlog/~3/XjlY2Nd47v8/christians-and-aggressive-end-of-life.html#comments Sat, 09 May 2015 01:28:00 +0000 http://www.bioethics.net/?guid=f9654769fd1c28bb998fdf5542ce72ef http://medicalfutility.blogspot.com/feeds/6598960197337453421/comments/default 0 When did same-sex marriage become morally acceptable to you? http://www.popbioethics.com/2015/05/when-did-same-sex-marriage-become-morally-acceptable-to-you/ http://www.popbioethics.com/2015/05/when-did-same-sex-marriage-become-morally-acceptable-to-you/#comments Fri, 08 May 2015 14:25:47 +0000 http://www.popbioethics.com/?p=3559 A same-sex marriage decision is due from the Supreme Court June. Given it has been almost exactly a decade since I changed my position on same-sex marriage, I figure now is a good time to reflect on the nature of that change.

Until about my sophomore year of college I was against same-sex marriage. Moreover [...]

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Delaware Passes POLST Bill (DMOST) http://feedproxy.google.com/~r/MedicalFutilityBlog/~3/H1Ny7mH0eVc/delaware-passes-polst-bill-dmost.html http://feedproxy.google.com/~r/MedicalFutilityBlog/~3/H1Ny7mH0eVc/delaware-passes-polst-bill-dmost.html#comments Fri, 08 May 2015 11:21:00 +0000 http://www.bioethics.net/?guid=a7427416d5a3cfaa6437f3debbf34a48 Yesterday, the Delaware Senate passed H.B. 64, which the House passed at the end of March. Once signed by the governor, this will add a new title 25A to title 16 of the Delaware Code:  "Delaware Medical Orders for Scope of Treatment Act” (DMOST Act)."

Getting a legal status for POLST in Delaware has been a long a bumpy road.  I review some of that here.

This summer, I will be assessing this and other new POLST and surrogate decision making statutes for the 2016 supplement to the RIGHT TO DIE legal reference treatise.

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Use of Unproven Interventions is Never Obligatory http://www.amc.edu/BioethicsBlog/post.cfm/use-of-unproven-interventions-is-never-obligatory http://www.amc.edu/BioethicsBlog/post.cfm/use-of-unproven-interventions-is-never-obligatory#comments Fri, 08 May 2015 08:05:30 +0000 http://www.bioethics.net/?guid=964d6034ee7d91b253cfcedd908cbcbc http://www.bioethics.net/2015/05/use-of-unproven-interventions-is-never-obligatory/feed/ 0