Bioethics.net » Health Care http://www.bioethics.net Where the World Finds Bioethics Fri, 03 Jul 2015 09:30:00 +0000 en-US hourly 1 http://wordpress.org/?v=4.0.1 Medical Futility Blog 2015-07-03 05:30:00 http://feedproxy.google.com/~r/MedicalFutilityBlog/~3/UbiaHD3kLoA/for-independence-day-weekend-i-am-happy.html http://feedproxy.google.com/~r/MedicalFutilityBlog/~3/UbiaHD3kLoA/for-independence-day-weekend-i-am-happy.html#comments Fri, 03 Jul 2015 09:30:00 +0000 http://www.bioethics.net/?guid=48b766f51062eabec329ba96fc46ccd9 http://medicalfutility.blogspot.com/feeds/5217003560484476423/comments/default 0 The Physical Impossibility of Death in the Mind of Someone Living [EOL in Art 53] http://feedproxy.google.com/~r/MedicalFutilityBlog/~3/RJMNC3GoSN8/the-physical-impossibility-of-death-in.html http://feedproxy.google.com/~r/MedicalFutilityBlog/~3/RJMNC3GoSN8/the-physical-impossibility-of-death-in.html#comments Fri, 03 Jul 2015 08:30:00 +0000 http://www.bioethics.net/?guid=c4fbf33343422a7f1cf80fda15b3c2d1 Damien Hirst's 1991 "The Physical Impossibility of Death in the Mind of Someone Living" forces the viewer out of their element by introducing into a gallery setting, a shark that was real enough to frighten you.  The work consists of a thirteen-foot tiger shark preserved in a tank of formaldehyde, weighing a total of 23 tons.

By isolating the shark from its natural habitat, with the formaldehyde providing an illusion of life, the work explores our greatest fears, and the difficulty involved in adequately trying to express them. Hirst states: “You try and avoid death, but it’s such a big thing that you can’t. That’s the frightening thing isn’t it?



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Jahi McMath – Re-litigating the Determination of Death http://feedproxy.google.com/~r/MedicalFutilityBlog/~3/XSMGkEY_pwE/jahi-mcmath-re-litigating-determination.html http://feedproxy.google.com/~r/MedicalFutilityBlog/~3/XSMGkEY_pwE/jahi-mcmath-re-litigating-determination.html#comments Thu, 02 Jul 2015 19:28:00 +0000 http://www.bioethics.net/?guid=c124f9a8906c6aa502b6d5b57f1457db http://medicalfutility.blogspot.com/feeds/3392472999607853956/comments/default 0 California Mom Christy O’Donnell Fights to Die on Her Own Terms http://feedproxy.google.com/~r/MedicalFutilityBlog/~3/nfOISeOjI74/california-mom-christy-odonnell-fights.html http://feedproxy.google.com/~r/MedicalFutilityBlog/~3/nfOISeOjI74/california-mom-christy-odonnell-fights.html#comments Thu, 02 Jul 2015 14:57:00 +0000 http://www.bioethics.net/?guid=32ffc305f892c8bc03c4e350bdce4145 I make a brief appearance in Katie Couric's interview of Christy O’Donnell about her fight to die on her own terms.



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After the Supreme Court Decision on Lethal Injection Drug, More Questions http://www.thehastingscenter.org/Bioethicsforum/Post.aspx?id=7464&blogid=140 http://www.thehastingscenter.org/Bioethicsforum/Post.aspx?id=7464&blogid=140#comments Thu, 02 Jul 2015 14:54:00 +0000 http://www.bioethics.net/?guid=05fbc7911de0ed5fd884e426887000ef Lillian Ringel and Stephanie Holmquist]]> http://www.bioethics.net/2015/07/after-the-supreme-court-decision-on-lethal-injection-drug-more-questions/feed/ 0 Even Superheroes Die [EOL in Art 52] http://feedproxy.google.com/~r/MedicalFutilityBlog/~3/4bv9wv2DJys/even-superheroes-die-eol-in-art-52.html http://feedproxy.google.com/~r/MedicalFutilityBlog/~3/4bv9wv2DJys/even-superheroes-die-eol-in-art-52.html#comments Thu, 02 Jul 2015 09:00:00 +0000 http://www.bioethics.net/?guid=d1e8f58c1112ddd1b997ebb64e5976cd http://medicalfutility.blogspot.com/feeds/3721856228362562974/comments/default 0 In California, Vaccination is the Law http://www.bioethics.net/2015/07/in-california-vaccination-is-the-law/ http://www.bioethics.net/2015/07/in-california-vaccination-is-the-law/#comments Wed, 01 Jul 2015 20:52:08 +0000 http://www.bioethics.net/?p=55611 by Craig Klugman, Ph.D.

This week, California governor Jerry Brown signed Senate Bill 277. This law mandates vaccinations for all children who attend a school (public or private) in the state. The only exemption is when a physician certifies that a vaccine “is not considered safe for the child.” The big change in this new law is the removal of the “personal belief” exemption from vaccination. No longer can a religious or philosophical belief exempt a child from receiving an immunization.…

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Bioethics Commission Recommends Multidisciplinary Efforts to Support Neuroscience and Ethics Research and Education http://blog.bioethics.gov/2015/07/01/bioethics-commission-recommends-multidisciplinary-efforts-to-support-neuroscience-and-ethics-research-and-education/ http://blog.bioethics.gov/2015/07/01/bioethics-commission-recommends-multidisciplinary-efforts-to-support-neuroscience-and-ethics-research-and-education/#comments Wed, 01 Jul 2015 17:35:42 +0000 http://blog.bioethics.gov/?p=1662 http://blog.bioethics.gov/2015/07/01/bioethics-commission-recommends-multidisciplinary-efforts-to-support-neuroscience-and-ethics-research-and-education/feed/ 0 Sexual morality and the goodness of God http://blogs.tiu.edu/bioethics/2015/07/01/sexual-morality-and-the-goodness-of-god/ http://blogs.tiu.edu/bioethics/2015/07/01/sexual-morality-and-the-goodness-of-god/#comments Wed, 01 Jul 2015 14:59:12 +0000 http://blogs.tiu.edu/bioethics/?p=6029 Read More »]]> http://blogs.tiu.edu/bioethics/2015/07/01/sexual-morality-and-the-goodness-of-god/feed/ 0 Legal Briefing: Adult Orphans and the Unbefriended: Making Medical Decisions for Unrepresented Patients without Surrogates http://feedproxy.google.com/~r/MedicalFutilityBlog/~3/V7hq5WEw-ow/legal-briefing-adult-orphans-and.html http://feedproxy.google.com/~r/MedicalFutilityBlog/~3/V7hq5WEw-ow/legal-briefing-adult-orphans-and.html#comments Wed, 01 Jul 2015 12:36:00 +0000 http://www.bioethics.net/?guid=51a2b313ff86cfba391e60020310b842 The summer 2015 issue of THE JOURNAL OF CLINICAL ETHICS is out.  I contributed "Legal Briefing: Adult Orphans and the Unbefriended: Making Medical Decisions for Unrepresented Patients without Surrogates."  

Here is the abstract:

This issue’s “Legal Briefing” column covers recent legal developments involving medical decision making for incapacitated patients who have no available legally authorized surrogate decision maker. These individuals are frequently referred to either as “adult orphans” or as “unbefriended,” “isolated,” or “unrepresented” patients. 

The challenges involved in obtaining consent for medical treatment on behalf of these individuals have been the subject of major policy reports. Indeed, caring for the unbefriended has even been described as the “single greatest category of problems” encountered in bioethics consultation.
      
In 2012, JCE published a comprehensive review of the available mechanisms by which to make medical decisions for the unbefriended. The purpose of this “Legal Briefing” is to update the 2012 study. Accordingly, this “Legal Briefing” collects and describes significant legal developments from only the past three years. 

My basic assessment has not changed. “Existing mechanisms to address the issue of decision making for the unbefriended are scant and not uniform.” Most facilities are “muddling through on an ad hoc basis.” 

But the situation is not wholly negative. There have been a number of promising new initiatives. I group these developments into the following seven categories:
  1. Increased Attention and Discussion
  2. Prevention through Better Advance Care Planning
  3. Prevention through Expanded Default Surrogate Lists
  4. Statutorily Authorized Intramural Mechanisms
  5. California Litigation Challenging the Team Approach
  6. Public Guardianship
  7. Improving Existing Guardianship Processes

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Mother with her Dead Son [EOL in Art 52] http://feedproxy.google.com/~r/MedicalFutilityBlog/~3/ZpaB7n0A9SQ/mother-with-her-dead-son-eol-in-art-52.html http://feedproxy.google.com/~r/MedicalFutilityBlog/~3/ZpaB7n0A9SQ/mother-with-her-dead-son-eol-in-art-52.html#comments Wed, 01 Jul 2015 09:30:00 +0000 http://www.bioethics.net/?guid=78438c3258db3ff4d6a1cfa591197c33 Käthe Kollwitz's sculpture "Mother with her Dead Son" at the Neue Wache emphasizes the loneliness and sadness.


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Estate Planning In the 21st Century: Seismic Shifts and Predictions for the Future – CFP http://feedproxy.google.com/~r/MedicalFutilityBlog/~3/i1o6Z8VE1pU/estate-planning-in-21st-century-seismic.html http://feedproxy.google.com/~r/MedicalFutilityBlog/~3/i1o6Z8VE1pU/estate-planning-in-21st-century-seismic.html#comments Tue, 30 Jun 2015 10:00:00 +0000 http://www.bioethics.net/?guid=f97c692662172c9d654e8e5838b124f4 http://medicalfutility.blogspot.com/feeds/251608984308196/comments/default 0 Vanitas [EOL in Art 51] http://feedproxy.google.com/~r/MedicalFutilityBlog/~3/sdQkLymgIuU/vanitas-eol-in-art-51.html http://feedproxy.google.com/~r/MedicalFutilityBlog/~3/sdQkLymgIuU/vanitas-eol-in-art-51.html#comments Tue, 30 Jun 2015 10:00:00 +0000 http://www.bioethics.net/?guid=30b68fdd81cd1fc548376b73f271ae4c http://medicalfutility.blogspot.com/feeds/7589147876246233452/comments/default 0 Ethical Issues at the End of Life – CFP http://feedproxy.google.com/~r/MedicalFutilityBlog/~3/jA0CssfejgI/ethical-issues-at-end-of-life-cfp.html http://feedproxy.google.com/~r/MedicalFutilityBlog/~3/jA0CssfejgI/ethical-issues-at-end-of-life-cfp.html#comments Tue, 30 Jun 2015 09:00:00 +0000 http://www.bioethics.net/?guid=dd6d7f5cfb104ccd8795de92cdb70ef2 http://medicalfutility.blogspot.com/feeds/703648332887364352/comments/default 0 Jahi McMath – Children’s Hospital Demurrer http://feedproxy.google.com/~r/MedicalFutilityBlog/~3/xIiof-ymnJE/jahi-mcmath-childrens-hospital-demurrer.html http://feedproxy.google.com/~r/MedicalFutilityBlog/~3/xIiof-ymnJE/jahi-mcmath-childrens-hospital-demurrer.html#comments Tue, 30 Jun 2015 01:28:00 +0000 http://www.bioethics.net/?guid=0aba4e0a873044856c0ef54e241f8e68 http://medicalfutility.blogspot.com/feeds/8216864752259696280/comments/default 0 Judge Strikes California Law that Allowed Nursing Homes to Make Medical Decisions for Unbefriended Residents http://feedproxy.google.com/~r/MedicalFutilityBlog/~3/wPW1W3EFk4w/judge-strikes-california-law-that.html http://feedproxy.google.com/~r/MedicalFutilityBlog/~3/wPW1W3EFk4w/judge-strikes-california-law-that.html#comments Mon, 29 Jun 2015 13:21:00 +0000 http://www.bioethics.net/?guid=fe04d184ee6a8359dda925d70c5f6f77 I just updated my prior articles on decision making for adult orphans, unbefriended, unrepresented patients without surrogates (forthcoming 26(2) J Clinical Ethics).  And then this.

A California law allowing nursing homes to make medical decisions on behalf of certain mentally incompetent residents is unconstitutional, a state court ruled this week.

The law, which has been in effect more than 20 years, gave nursing homes authority to decide residents’ medical treatment if a doctor determined they were unable to do so and they had no one to represent them.

Alameda County Superior Court Judge Evelio M. Grillo wrote in the June 24 decision that the law violates patients’ due process rights because it doesn’t require nursing homes to notify patients they have been deemed incapacitated or to give them the chance to object.

Grillo acknowledged the decision is likely to “create problems” in how nursing home operate but wrote that patients’ rights are more compelling.

“The stakes are simply too high to hold otherwise,” the judge wrote. Any error could deprive patients of their rights to make medical decisions that “may result in significant consequences, including death.”

The medical decisions on incapacitated residents without representatives are made by a team that includes a physician and a nurse.

The fact that nursing homes are making end-of-life decisions without patient input is a big concern, according to the ruling. The decision cited one nursing home resident who was found to be mentally incapacitated and who had no representative. The facility staff made a decision to take him off life-sustaining treatment and he passed away in 2013.

The ruling came after the California Advocates for Nursing Home Reform, an advocacy group, filed a lawsuit in 2013 against the state Department of Public Health. The suit alleged that nursing homes used the law to administer anti-psychotic drugs, place residents in physical restraints and deny patients life-sustaining treatment.

Tony Chicotel, a staff attorney for the group, said the ruling will dramatically impact the lives of the most vulnerable nursing home residents.

“What [nursing homes] used to do was routinely make decisions big and small for their residents without really any regard to due process,” Chicotel said. “Now the residents are finally going to have their rights acknowledged and honored.”

Even patients who are compromised should still have a say in their medical care, he added.

“They have been ignored,” he said. “Unrepresented residents and the way they are treated in nursing homes has never been a priority of the Department of Public Health.”

The department is reviewing the decision, a spokesman said. Department officials declined to comment further or say whether they planned to appeal.

The law was enacted in 1992 because nursing facilities needed a way to give medical treatment to their incapacitated residents without having to wait up to six months for state approval, according to the ruling.

But the decision could make it challenging for nursing homes to provide routine medical care or to offer hospice care to residents who lack the mental capacity to make their own decisions and have no designated representatives, said Mark Reagan, an attorney representing the trade group, California Association of Health Facilities, which is not part of the lawsuit.

“If the person objects, then what?” Reagan said. “That can put patients and facilities in a difficult place.”

And seeking court approval to provide anti-psychotic medication to residents who truly need it would be costly and time-consuming for nursing facilities, he said. “How do you keep that person safe and how do you keep the other residents of the skilled nursing facility safe?” he said.

Reagan believes the ruling could have an unanticipated outcome: Patients without decision-makers could have a hard time finding a nursing facility willing to take them.

“If this decision makes it more difficult to supply necessary care at the bedside, this population is going to be less served,” he said.

The judge, however, wrote that informing patients and allowing them to object is not likely to result in any significant burdens on nursing homes.

Golden Gate University Law School Professor Mort Cohen, who filed the case, said the next step is for the judge to issue an order directing the state Department of Public Health, which oversees nursing homes statewide. The state could ask the court for a stay or could appeal the decision, but Cohen said he expects the decision to stick.

[From Kaiser Health News (KHN), a nonprofit national health policy news service.]]]>
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iPhone App Will Track Sexual Activity and Reproduction http://www.amc.edu/BioethicsBlog/post.cfm/iphone-app-will-track-sexual-activity-and-reproduction http://www.amc.edu/BioethicsBlog/post.cfm/iphone-app-will-track-sexual-activity-and-reproduction#comments Mon, 29 Jun 2015 10:06:00 +0000 http://www.bioethics.net/?guid=dd762870d29f1e7cafd060b13a1e674b http://www.bioethics.net/2015/06/iphone-app-will-track-sexual-activity-and-reproduction/feed/ 0 Relics – Film on Assisted Death [EOL in Art 50] http://feedproxy.google.com/~r/MedicalFutilityBlog/~3/O2INpP4mF8I/relics-film-on-assisted-death-eol-in.html http://feedproxy.google.com/~r/MedicalFutilityBlog/~3/O2INpP4mF8I/relics-film-on-assisted-death-eol-in.html#comments Mon, 29 Jun 2015 09:00:00 +0000 http://www.bioethics.net/?guid=34853d14dab5706d7cb02d6394be9e06 http://medicalfutility.blogspot.com/feeds/8493254106818887455/comments/default 0 Support Informing Bioethics Policy http://feedproxy.google.com/~r/MedicalFutilityBlog/~3/6RW19Kht-PE/support-informing-bioethics-policy.html http://feedproxy.google.com/~r/MedicalFutilityBlog/~3/6RW19Kht-PE/support-informing-bioethics-policy.html#comments Mon, 29 Jun 2015 08:30:00 +0000 http://www.bioethics.net/?guid=b4cefd316f377354b4d0626d934c556f http://medicalfutility.blogspot.com/feeds/1831109779155405664/comments/default 0 Heartfelt – Photography of Troubled Births [EOL in Art 49] http://feedproxy.google.com/~r/MedicalFutilityBlog/~3/M45jYk2Y-pQ/heartfelt-photography-of-troubled.html http://feedproxy.google.com/~r/MedicalFutilityBlog/~3/M45jYk2Y-pQ/heartfelt-photography-of-troubled.html#comments Sun, 28 Jun 2015 09:30:00 +0000 http://www.bioethics.net/?guid=fd7eb0c51bec0c552f622676b73dcd53 http://medicalfutility.blogspot.com/feeds/4170744572642196228/comments/default 0 Art of Hospice [EOL in Art 48] http://feedproxy.google.com/~r/MedicalFutilityBlog/~3/2JTjtGRpuME/art-of-hospice-eol-in-art-48.html http://feedproxy.google.com/~r/MedicalFutilityBlog/~3/2JTjtGRpuME/art-of-hospice-eol-in-art-48.html#comments Sat, 27 Jun 2015 08:00:00 +0000 http://www.bioethics.net/?guid=6e3fdcee6ef75e00cf2363d71334ff36 http://medicalfutility.blogspot.com/feeds/1554221466209644266/comments/default 0 PATIENT-CENTERED RESEARCH CAN IMPROVE CHRONIC PAIN CARE AND ADDRESS OPIOID ABUSE http://practicalbioethics.blogspot.com/2015/06/patient-centered-research-can-improve.html http://practicalbioethics.blogspot.com/2015/06/patient-centered-research-can-improve.html#comments Fri, 26 Jun 2015 19:27:00 +0000 http://www.bioethics.net/?guid=1e7e4f74738f5c2b4d9e5c66597c8e90 Going for the Brass RingLast year, Joe Selby, MD, executive director of the Patient-Centered Outcomes Research Institute (PCORI), spoke to members of the NIH Interagency Pain Research Coordinating Committee (PCORI) to inform those of us on the committee about PCORI’s intentions to do more funding focused on chronic pain research. Dr. Selby said their interests were possibly in low back pain, migraine, musculoskeletal pain, and/or opioid abuse. I was elated. Then about a month ago (May 14, 2015), Dr. Selby posted a blog on the PCORI website titled, “Patient-Centered Research Can Improve Chronic Pain Care and Address Opioid Abuse.” 

I hope with all my heart that he is right; research or policy that can do both of these things is like grabbing the brass ring while on a merry-go-round. It is certainly a worthy goal but, to many, seems all but impossible. If anybody can do this, however, PCORI may have the best chance. Established by the Patient Protection/Affordable Care Act in 2010, PCORI’s mission is to “examine the relative health outcomes, clinical effectiveness, and appropriateness of different medical treatments” – particularly complex problems that threaten the health and well-being of all Americans. Chronic pain certainly meets that criterion.

In Dr. Selby’s blog, he said, “Since 2012, PCORI has built a sizeable portfolio of studies on chronic pain, two of which specifically address opioid treatment.” He went on to list some of the questions these studies have focused on:

  • How can we improve patients’ ability to communicate confidently with doctors about pain and pain medication?
  • What approaches to care delivery can minimize health and safety risks when long-term opioid use is considered?
  • What collaborative-care approaches to pain can improve quality of life, patient satisfaction, and adherence to other treatments?
  • How can we encourage patients to join and stay enrolled in integrative treatment plans that show promise of reducing chronic pain while lowering risk for opioid abuse?

He also informed readers that, in June, PCORI would be hosting “multi-stakeholder workshops” to discuss whether comparative effectiveness research (CER) can be helpful in addressing these issues. 

The week before Dr. Selby posted his blog, I was pleased to receive a letter from him inviting the Pain Action Alliance to Implement a National Strategy (PAINS) to send four representatives to two workshops in Washington, DC – one focused on low back pain and the other on long-term use of opioids in the treatment of pain. We quickly accepted, and on the morning of June 8, two members of the PAINS team and two of our Citizen/Leaders (people living with chronic pain and/or family members caring for chronic pain sufferers) went to the airport excited about traveling to our nation’s Capitol and participating in these important discussions. After six hours at the airport and our second plane cancellation due to mechanical problems in Kansas City and bad weather in DC, I emailed our PCORI contact to tell him that we would not be coming to DC, and we headed home with heavy hearts. 

The next day, I tried to participate in the opioid workshop remotely, but technical difficulties that even their “help desk” didn’t seem to be able to overcome, made it all but impossible for me to do so. I must say, however, that I am grateful to one of the meeting participants and the facilitator of the “opioid workshop” for their extraordinary efforts to include me. I am also grateful that the next day the PCORI facilitator sent me the rank-ordered questions that emerged from the workshop and gave me permission to share them. They are very interesting, and can be seen at:  

http://www.pcori.org/events/2015/prioritizing-comparative-effectiveness-research-questions-long-term-use-opioids-chronic

That afternoon I wrote to Dr. Selby to express our gratitude for PCORI’s interest in chronic pain and to explain to him why PAINS representatives were not at the workshops the day before. I said that it is our view that, “PCORI is essential to the ‘cultural transformation in the way pain is perceived, judged and treated’ called for in the IOM report, Relieving Pain in America, and echoed in the forthcoming National Pain Strategy Report.” I also invited him and/or others at PCORI who he would deem appropriate to visit Kansas City to meet with our team and PAINS’ Citizen/Leaders. I told him that our Citizen/Leader Group has met with and advised us for more than two years and that they have been enormously helpful. I encouraged him to activate the following link (and click the link there to the video, “The Faces of Pain”), so that he could meet some of these outstanding individuals:

http://practicalbioethics.org/resources/chronic-pain-resources

I also suggested that these remarkable people and others like them could be very helpful to PCORI, in fact, I believe, essential, as they build out their pain portfolio. I also offered to arrange for us to come to DC if it was not possible for them to come to Kansas City.

The ambitious goal PCORI has set -- comparative effectiveness research that will improve chronic pain care and address opioid abuse -- will require the involvement of many stakeholders. The most important among those may well be people who struggle to live with chronic pain and family members who care for them day-after-day. PCORI’s very name implies that they understand that. I look forward to hearing from Dr. Selby and welcoming him and others to Kansas City. In the meantime, I can almost hear the calliope music on the merry-go-round.

By Myra J. Christopher

Myra J. Christopher is the Kathleen M. Foley Chair in Pain and Palliative Care at the Center for Practical Bioethics and Director of PAINS.

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Supreme Court Decision in King v Burwell: Backstory and Next Steps http://www.thehastingscenter.org/Bioethicsforum/Post.aspx?id=7459&blogid=140 http://www.thehastingscenter.org/Bioethicsforum/Post.aspx?id=7459&blogid=140#comments Fri, 26 Jun 2015 14:54:00 +0000 http://www.bioethics.net/?guid=d061921d358a2755ce889c01aa7541c3 http://www.bioethics.net/2015/06/supreme-court-decision-in-king-v-burwell-backstory-and-next-steps/feed/ 0 Hospice [EOL in Art 47] http://feedproxy.google.com/~r/MedicalFutilityBlog/~3/AwtVosnNc7w/hospice-eol-in-art-47.html http://feedproxy.google.com/~r/MedicalFutilityBlog/~3/AwtVosnNc7w/hospice-eol-in-art-47.html#comments Fri, 26 Jun 2015 09:00:00 +0000 http://www.bioethics.net/?guid=1594476ee154ffa24736f60abab2f5c2 http://medicalfutility.blogspot.com/feeds/4720833524797524359/comments/default 0 No Immunity for Providers Who Treated Patient Contrary to Her Advance Directive http://feedproxy.google.com/~r/MedicalFutilityBlog/~3/LH06xwpH8Hs/no-immunity-for-providers-who-treated.html http://feedproxy.google.com/~r/MedicalFutilityBlog/~3/LH06xwpH8Hs/no-immunity-for-providers-who-treated.html#comments Fri, 26 Jun 2015 08:30:00 +0000 http://www.bioethics.net/?guid=3c8b5908f8ec279211e840694c32dec2 http://medicalfutility.blogspot.com/feeds/5839209189287455526/comments/default 0 Pluralism, Futility, and Thresholds for Treatment in Intensive Care http://feedproxy.google.com/~r/MedicalFutilityBlog/~3/-zp0b2a9mw8/pluralism-futility-and-thresholds-for.html http://feedproxy.google.com/~r/MedicalFutilityBlog/~3/-zp0b2a9mw8/pluralism-futility-and-thresholds-for.html#comments Fri, 26 Jun 2015 07:00:00 +0000 http://www.bioethics.net/?guid=0d70a6d29712783bca8e5189d2f07377 http://medicalfutility.blogspot.com/feeds/6463652944602040243/comments/default 0 SCOTUS Has Ruled on Obamacare. So What’s Next? http://www.peterubel.com/health_policy/scotus-ruled-obamacare-whats-next/ http://www.peterubel.com/health_policy/scotus-ruled-obamacare-whats-next/#comments Thu, 25 Jun 2015 19:11:22 +0000 http://www.peterubel.com/?p=7539 In a 6-3 decision, the Supreme Court Thursday spared the Affordable Care Act from what would have been a death blow. The Court’s action upholds the right of the federal government to subsidize low-income Americans who purchase health insurance through … Continue reading

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Mandatory Vaccinations??? https://denasusandavis.wordpress.com/2015/06/25/mandatory-vaccinations/ https://denasusandavis.wordpress.com/2015/06/25/mandatory-vaccinations/#comments Thu, 25 Jun 2015 18:36:51 +0000 http://denasusandavis.wordpress.com/?p=44 ]]> https://denasusandavis.wordpress.com/2015/06/25/mandatory-vaccinations/feed/ 0 What Physicians Can Learn from Veterinarians http://www.peterubel.com/health_policy/physicians-can-learn-veterinarians/ http://www.peterubel.com/health_policy/physicians-can-learn-veterinarians/#comments Thu, 25 Jun 2015 15:03:13 +0000 http://www.peterubel.com/?p=7535 A while back, I linked to a story by Rebecca Plevin, out of California Public Radio, on the challenge of discussing health care costs.  Well, she has tuned up that piece and placed it on Marketplace. Here is a print … Continue reading

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Hospice Stamp [EOL in Art 46] http://feedproxy.google.com/~r/MedicalFutilityBlog/~3/JBkqRd7_ZWI/hospice-stamp-eol-in-art-46.html http://feedproxy.google.com/~r/MedicalFutilityBlog/~3/JBkqRd7_ZWI/hospice-stamp-eol-in-art-46.html#comments Thu, 25 Jun 2015 09:00:00 +0000 http://www.bioethics.net/?guid=f480d46578cf5f2c7e1e784e4f136028 In 1999, the U.S. Postal Service issued the Hospice Care Commerative Stamp to help raise awareness about hospice.

The stamp was designed by veteran stamp designer Phil Jordan to symbolize life’s journey to its final stage, the stage where Hospice lends its vision for end-of-life care.  The Hospice stamp features a large green field in front and a tree beside a while house, with a large yellow and red butterfly flying above. 


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SNF Fined $400,000 for Blindly Following the Surrogate http://feedproxy.google.com/~r/MedicalFutilityBlog/~3/bfgicVs9ZHE/snf-fined-400000-for-blindly-following.html http://feedproxy.google.com/~r/MedicalFutilityBlog/~3/bfgicVs9ZHE/snf-fined-400000-for-blindly-following.html#comments Thu, 25 Jun 2015 08:00:00 +0000 http://www.bioethics.net/?guid=96869737f9601cc4abf13db8efb4c1bc Earlier this week, I wrote about a recent CMS investigation in which a hospital wrongly looked to a surrogate even though the patient still had capacity to make her own healthcare decisions.  Today, I summarize a similar case from the DHHS Departmental Appeals Board in which the facility was fine nearly $400,000.

NMS Healthcare of Hagerstown is a skilled nursing facility.  It confined one of its residents and restricted her access to members of her family and others.  NMS did this at the request of the resident's daughter even though there was no medical or other basis for doing so.

The ALJ observed:  "A skilled nursing facility is not excused of its obligations to provide care by the fact that a resident or someone on the resident’s behalf demands that the facility provide a certain type or level of care. The regulations governing skilled nursing facilities do not allow facilities to abdicate their responsibilities to residents in order to cater to the whims of residents’ family members, whether or not they have POAs."

"Moreover, a facility is not inherently a neutral arbiter. There can be a conflict of interest between a facility and its resident. . . . Resident # 4 generated a steady stream of revenue to Petitioner . . . .  Given that potential conflict of interest it was incumbent on Petitioner to be scrupulously neutral in dealing with the resident. Simply going along with JF’s wishes in this case – without independently assessing the resident to determine whether confining her and restricting her access to visitors was appropriate – was anything but neutral."

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Aid in Dying – Minnesota http://feedproxy.google.com/~r/MedicalFutilityBlog/~3/zSrw0ddpMCY/aid-in-dying-minnesota.html http://feedproxy.google.com/~r/MedicalFutilityBlog/~3/zSrw0ddpMCY/aid-in-dying-minnesota.html#comments Wed, 24 Jun 2015 20:54:00 +0000 http://www.bioethics.net/?guid=70ab58ac56ec6eddb5e4fd0332cf9e9c http://medicalfutility.blogspot.com/feeds/921778900372891434/comments/default 0 Your New Liver Is Only A Learjet Away: First Of Three Parts http://www.peterubel.com/uncategorized/new-liver-learjet-away-first-three-parts/ http://www.peterubel.com/uncategorized/new-liver-learjet-away-first-three-parts/#comments Wed, 24 Jun 2015 17:33:38 +0000 http://www.peterubel.com/?p=7529 The forty million dollar Gulfstream jet landed at Memphis International airport in the early morning hours, its schedule hastily arranged earlier that day from Northern California, where the flight originated. Waiting on the tarmac was Dr. James Eason, head of … Continue reading

The post Your New Liver Is Only A Learjet Away: First Of Three Parts appeared first on PeterUbel.com.

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New Primer for Researchers on Neuroscience and Consent Capacity Now Available http://blog.bioethics.gov/2015/06/24/new-primer-for-researchers-on-neuroscience-and-consent-capacity-now-available/ http://blog.bioethics.gov/2015/06/24/new-primer-for-researchers-on-neuroscience-and-consent-capacity-now-available/#comments Wed, 24 Jun 2015 16:20:35 +0000 http://blog.bioethics.gov/?p=1659 http://blog.bioethics.gov/2015/06/24/new-primer-for-researchers-on-neuroscience-and-consent-capacity-now-available/feed/ 0 Bioethics and Gnosticism http://blogs.tiu.edu/bioethics/2015/06/24/bioethics-and-gnosticism/ http://blogs.tiu.edu/bioethics/2015/06/24/bioethics-and-gnosticism/#comments Wed, 24 Jun 2015 15:23:30 +0000 http://blogs.tiu.edu/bioethics/?p=6025 Read More »]]> http://blogs.tiu.edu/bioethics/2015/06/24/bioethics-and-gnosticism/feed/ 0 Rats Have Empathy, But What About the Scientists Who Experiment on Them? http://www.thehastingscenter.org/Bioethicsforum/Post.aspx?id=7458&blogid=140 http://www.thehastingscenter.org/Bioethicsforum/Post.aspx?id=7458&blogid=140#comments Wed, 24 Jun 2015 14:54:00 +0000 http://www.bioethics.net/?guid=611adfcf4d0a298b99b3e10ccf7f2a43 Alka Chandna]]> http://www.bioethics.net/2015/06/rats-have-empathy-but-what-about-the-scientists-who-experiment-on-them/feed/ 0 Process of Dying in 6 Paintings [EOL in Art 45] http://feedproxy.google.com/~r/MedicalFutilityBlog/~3/0Que4jq2JNk/process-of-dying-in-6-paintings-eol-in.html http://feedproxy.google.com/~r/MedicalFutilityBlog/~3/0Que4jq2JNk/process-of-dying-in-6-paintings-eol-in.html#comments Wed, 24 Jun 2015 09:00:00 +0000 http://www.bioethics.net/?guid=22aefda9cc02a29a290c748b55e44b46 http://medicalfutility.blogspot.com/feeds/77551732162518403/comments/default 0 Considering best care for extremely premature babies http://blogs.tiu.edu/bioethics/2015/06/23/considering-best-care-for-extremely-premature-babies/ http://blogs.tiu.edu/bioethics/2015/06/23/considering-best-care-for-extremely-premature-babies/#comments Wed, 24 Jun 2015 00:05:24 +0000 http://blogs.tiu.edu/bioethics/?p=6021 Read More »]]> http://blogs.tiu.edu/bioethics/2015/06/23/considering-best-care-for-extremely-premature-babies/feed/ 0 Jahi McMath Malpractice Lawsuit – June 2015 Update http://feedproxy.google.com/~r/MedicalFutilityBlog/~3/JHwHN0JAoFg/jahi-mcmath-malpractice-lawsuit-june.html http://feedproxy.google.com/~r/MedicalFutilityBlog/~3/JHwHN0JAoFg/jahi-mcmath-malpractice-lawsuit-june.html#comments Tue, 23 Jun 2015 19:13:00 +0000 http://www.bioethics.net/?guid=fee8bc66bcbe50278a94470bb43fd771 http://medicalfutility.blogspot.com/feeds/793261823203594919/comments/default 0 Time and Death [EOL in Art 44] http://feedproxy.google.com/~r/MedicalFutilityBlog/~3/tEv45pjBmyo/time-and-death-eol-in-art-44.html http://feedproxy.google.com/~r/MedicalFutilityBlog/~3/tEv45pjBmyo/time-and-death-eol-in-art-44.html#comments Tue, 23 Jun 2015 10:00:00 +0000 http://www.bioethics.net/?guid=33f7cbeacbb8bcb30e71e59d1ebbdd52 http://medicalfutility.blogspot.com/feeds/7614036030581243924/comments/default 0 NIH Emeritus Grant: Letting in the New Crop and Kicking the Old Out http://www.amc.edu/BioethicsBlog/post.cfm/nih-emeritus-grant-letting-in-the-new-crop-and-kicking-the-old-out http://www.amc.edu/BioethicsBlog/post.cfm/nih-emeritus-grant-letting-in-the-new-crop-and-kicking-the-old-out#comments Tue, 23 Jun 2015 09:06:01 +0000 http://www.bioethics.net/?guid=5db75cdbc1593b468195be8f470e6605 http://www.bioethics.net/2015/06/nih-emeritus-grant-letting-in-the-new-crop-and-kicking-the-old-out/feed/ 0 The Issue of Physician Motive in Physician-Assisted Suicide http://blogs.tiu.edu/bioethics/2015/06/22/the-issue-of-physician-motive-in-physician-assisted-suicide/ http://blogs.tiu.edu/bioethics/2015/06/22/the-issue-of-physician-motive-in-physician-assisted-suicide/#comments Tue, 23 Jun 2015 01:45:50 +0000 http://blogs.tiu.edu/bioethics/?p=6013 Read More »]]> http://blogs.tiu.edu/bioethics/2015/06/22/the-issue-of-physician-motive-in-physician-assisted-suicide/feed/ 0 Aid in Dying – Minnesota Public Radio http://feedproxy.google.com/~r/MedicalFutilityBlog/~3/-aC5kDioGDc/aid-in-dying-minnesota-public-radio.html http://feedproxy.google.com/~r/MedicalFutilityBlog/~3/-aC5kDioGDc/aid-in-dying-minnesota-public-radio.html#comments Mon, 22 Jun 2015 22:25:00 +0000 http://www.bioethics.net/?guid=edb1129925ec15c5f01e147c58cd0efb http://medicalfutility.blogspot.com/feeds/7691161860991338214/comments/default 0 Death Listens [EOL in Art 43] http://feedproxy.google.com/~r/MedicalFutilityBlog/~3/lRWhRfhBAZw/death-listens-eol-in-art-43.html http://feedproxy.google.com/~r/MedicalFutilityBlog/~3/lRWhRfhBAZw/death-listens-eol-in-art-43.html#comments Mon, 22 Jun 2015 09:30:00 +0000 http://www.bioethics.net/?guid=48d210664cd4b8842036aa3d1b5da890 http://medicalfutility.blogspot.com/feeds/4044756970672272014/comments/default 0 Atul Gawande in Minnesota (Sept. 18, 2015) http://feedproxy.google.com/~r/MedicalFutilityBlog/~3/2ZRCctNjczU/atul-gawande-in-minnesota-sept-18-2015.html http://feedproxy.google.com/~r/MedicalFutilityBlog/~3/2ZRCctNjczU/atul-gawande-in-minnesota-sept-18-2015.html#comments Mon, 22 Jun 2015 09:00:00 +0000 http://www.bioethics.net/?guid=e25bd53f8d3ff815e7be7446b2bfb9f0 http://medicalfutility.blogspot.com/feeds/3161312380785023902/comments/default 0 Do Not Look to the Surrogate If the Patient Still Has Capacity http://feedproxy.google.com/~r/MedicalFutilityBlog/~3/lsJNjBkYFnI/do-not-look-to-surrogate-if-patient.html http://feedproxy.google.com/~r/MedicalFutilityBlog/~3/lsJNjBkYFnI/do-not-look-to-surrogate-if-patient.html#comments Mon, 22 Jun 2015 09:00:00 +0000 http://www.bioethics.net/?guid=b1936afafb979ccc75edbbdf02936971 http://medicalfutility.blogspot.com/feeds/133366424642845677/comments/default 0 Letter Remained Unfinished [EOL in Art 42] http://feedproxy.google.com/~r/MedicalFutilityBlog/~3/DQ7ZOBZxg78/letter-remained-unfinished-eol-in-art-42.html http://feedproxy.google.com/~r/MedicalFutilityBlog/~3/DQ7ZOBZxg78/letter-remained-unfinished-eol-in-art-42.html#comments Sun, 21 Jun 2015 09:00:00 +0000 http://www.bioethics.net/?guid=6cd2a25dc81a759d61f4b83a8b40be28 http://medicalfutility.blogspot.com/feeds/3435133582196021785/comments/default 0 Ontario Medical Board Cautions Physicians for Writing Unilateral DNR Order (Wawrzyniak v. Chapman & Livingstone) http://feedproxy.google.com/~r/MedicalFutilityBlog/~3/rhsRYJ0Ki0E/ontario-medical-board-cautions.html http://feedproxy.google.com/~r/MedicalFutilityBlog/~3/rhsRYJ0Ki0E/ontario-medical-board-cautions.html#comments Sun, 21 Jun 2015 08:30:00 +0000 http://www.bioethics.net/?guid=c4d3619986e5988846ce6f7b0ae2c1fe http://medicalfutility.blogspot.com/feeds/836647082823204559/comments/default 0 ASBH Annual Meeting (October 2015) http://feedproxy.google.com/~r/MedicalFutilityBlog/~3/wmmZq-WZGaE/asbh-annual-meeting-october-2015.html http://feedproxy.google.com/~r/MedicalFutilityBlog/~3/wmmZq-WZGaE/asbh-annual-meeting-october-2015.html#comments Sat, 20 Jun 2015 21:24:00 +0000 http://www.bioethics.net/?guid=ada6ebe10bca82f240133e635fc3e418 http://medicalfutility.blogspot.com/feeds/1844523601928798337/comments/default 0 Hospital Sanctioned for Patients Lacking POLST http://feedproxy.google.com/~r/MedicalFutilityBlog/~3/GXLVB9xWqTE/hospital-sanctioned-for-patients.html http://feedproxy.google.com/~r/MedicalFutilityBlog/~3/GXLVB9xWqTE/hospital-sanctioned-for-patients.html#comments Sat, 20 Jun 2015 10:00:00 +0000 http://www.bioethics.net/?guid=2253686adc724bf6d98c395b9fa084f0 http://medicalfutility.blogspot.com/feeds/3736426060419901665/comments/default 0