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For three years during the 1960s, I worked for various organizations, all of us trying to end the War in Vietnam.  At one point, I was employed by the Fifth Avenue Peace Parade Committee, while my boyfriend worked for the Student Mobilization to End the War in Vietnam (affectionately known as “The Mobe”).  Both of … Continue reading Coronavirus Contact Tracing

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Check out this course at Cardiff University. It explores how (un)consciousness, coma and the vegetative state are represented in the media. 

This course allows you to engage with debates about the portrayal of patients and reporting of  ‘miracle’ recoveries, court cases and scientific breakthroughs. It addresses implications for family and public understandings. This course will help develop your understanding of ‘coma’ and your skills in writing for the media or being a critical media consumer or researcher, or supporting patients and their families.

I like this page which includes interviews and commentaries on key cases like Nancy Cruzan, Aruna Shanbaug, an Eluana Englaro.

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In his recent JAMA article, Donald Berwick eloquently describes what he termed the “moral determinants of health,” by which he meant a strong sense of social solidarity in which people in the United States would “depend on each other for securing the basic circumstances of healthy lives,” reflecting a “moral law within.” Berwick’s work should serve as a call to action for bioethicists and clinical ethicists to consider what they can do to be forces of broad moral change in their institutions.

The post Ethicists as a Force for Institutional Change and Policies to Promote Equality appeared first on The Hastings Center.

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by Craig Klugman, Ph.D.

Tommye Austin is senior vice president and chief nursing officer at University Hospital in San Antonio. Like most Texas hospitals, UH has been hard hit by the pandemic in recent weeks and PPE is in short supply. Nurse Austin created a crafty N95 replacement mask that uses cloth fabric and air conditioning filters. She is passionate about masks and people protecting themselves from COVID-19. She regularly posts on social media and has spoken to the media about face coverings.

In late June, to further help her city and social media followers understand why wearing a mask is so important, Austin made a video of recording of her intubation.…

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07/08/2020 Fanon is French

I’m re-reading Black Skin, White Masks as part of a “remember your critical theory so that you can defend it or critique it from a place of knowledge rather than memory” sort of process. I’m alternating between the 2020 best sellers and the critical canon. Between the World and Me was first, now Fanon (going [...]

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by Kei Mukohara, MD, Ph.D., Tsunetoshi Mogi, MD

COVID-19 REGISRY JAPAN(COVIREGI-JP, its official website [In Japanese])is an ongoing government-funded national registry study conducted principally at the National Center for Global Health and Medicine in collaboration with Fujita Health University, Hokkaido University, National Institute of Infectious Diseases and pharmaceutical companies. To create a national registry, it is requesting participating institutions to provide clinical data on hospitalized patients with COVID-19. The study is enrolling patients retrospectively and prospectively from January 1, 2020 to January 31, 2021. One of its objectives is to investigate safety and effectiveness of experimental administration of various candidate medications for COVID-19 including favipiravir, lopinavir-ritonavir, interferons, neuraminidase inhibitors, remdesivir, and ciclesonide, all of which except remdesivir are not yet approved for use in patients with COVID-19 in Japan.…

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This month, the Society for Post-Acute and Long-Term Care Medicine (AMDA) became the first national organization to formally endorse and support the adoption of a national POLST form.

The national form was created because a single form—as opposed to just state-to-state form reciprocity—will make it easier, among other things:

  • For providers to recognize a POLST form and  correctly interpret and follow POLST form orders, thereby enabling them to honor patient treatment preferences
  • To conduct research and quality assurance activities, creating shared data for generalizable knowledge and ability to improve POLST
  • To more broadly educate patients and providers about POLST so the process and form are understood and appropriately implemented consistently everywhere

While not solely for emergencies, the POLST form is valuable in communicating to EMS providers whether the patient wants CPR or not and whether they want to be transported to the hospital or remain in place and made comfortable. Therefore, the POLST form itself must be immediately recognizable to all EMS providers and healthcare professionals.

“POLST exists to provide seriously ill or frail patients a tool to communicate their treatment preferences as they transition across care settings or travel throughout the United States.” (Amy Vandenbroucke, JD, executive director of National POLST).

POLST is an approach to advance care planning for patients who are considered to be at risk for a life-threatening clinical event because they have a serious life-limiting medical condition, which may include advanced frailty. The POLST process emphasizes eliciting, documenting, and honoring patient preferences about the treatments they want to receive during a medical emergency or as they decline in health. These treatment wishes are documented on a portable medical order called a POLST form.

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Several states, including Ohio, Alabama, Arkansas, Texas, Iowa, and Oklahoma, declared abortion a nonessential service at some point during the pandemic, meaning that it was effectively banned until the crisis passed. Supporters of the policies maintain that abortion is an elective procedure whose medical resources are better off used in the fight against the pandemic. But abortion opponents have been taking advantage of the current circumstances to limit abortion access.

The post Using the Pandemic as an Excuse to Limit Abortion appeared first on The Hastings Center.

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by Amy C. Reese, Pharm.D.

My pharmacy received a prescription for prednisolone solution written for a 5-year-old patient. We only had the manufacturer of prednisolone with 5% alcohol in it as a solvent. I did not want to deny the child medication, but I was hesitant about giving medication with alcohol to a child because some people are strictly opposed to the practice of giving children alcohol. When the mother arrived at the pharmacy, I explained the situation to her and told her what her options were. She could chose to give her child the prednisolone with alcohol or she could abstain from picking up the prescription.…

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The Washington Post has compelling coverage  of the Austin, Texas case in which clinicians withdrew life-sustaining treatment from Michael Hickson over the objections of his wife and apparently on the basis of his unrelated disabilities. Yet, per...

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