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April 23, 2014

Senate Passes End-of-Life Planning Bill

(Yale Daily News) – The Connecticut Senate passed a bill on Thursday that, with House approval, would create a system for terminally ill people to declare their wishes for end-of-life care. The Medical Orders for Life-sustaining Treatment (MOLST) bill, which passed the Senate with a unanimous vote, would create a two year pilot program in two different locations in the state for people with terminal illnesses to discuss with healthcare providers how much treatment they want, from limited care to life-support treatment.

A New Edition of JAMA Internal Medicine is Available

JAMA Internal Medicine (Volume 174, No. 4, April 2014) is now available online by subscription only.

Articles include:

  • “23andMe, the Food and Drug Administration, and the Future of Genetic Testing” by Patricia J. Zettler, Jacob S. Sherkow, and Henry T. Greely
  • “National Hospice Survey Results:  For-Profit Status, Community Engagement, and Service” by Melissa D. Aldridge, et al.
  • “The Changing Face of the Hospice Industry:  What Really Matters?” by Kimberly S. Johnson
  • “The Importance of Influenza Vaccination” by Hilary M. Babcock, John A. Jernigan, and David A. Relman
  • “The Importance of Influenza Vaccination—Reply” by Peter Doshi

April 22, 2014

A New Edition of Ethical Theory and Moral Practice is Available

Ethical Theory and Moral Practice (Volume 17, No. 2, April 2014) is now available online by subscription only.

Articles include:

  • “Life in Overabundance: Agar on Life-Extension and the Fear of Death” by Aveek Bhattacharya & Robert Mark Simpson
  • “Seeking a Variable Standard of Individual Moral Responsibility in Organizations” by Michael Skerker

A New Edition of Medicine, Health Care and Philosophy is Available

Medicine, Health Care and Philosophy (Volume 17, No. 2, May 2014) is now available online by subscription only.

Articles include:

  • “Neither property right nor heroic gift, neither sacrifice nor aporia: the benefit of the theoretical lens of sharing in donation ethics” by Kristin Zeiler
  • “The relevance of the philosophical ‘mind–body problem’ for the status of psychosomatic medicine: a conceptual analysis of the biopsychosocial model” by Lukas Van Oudenhove & Stefaan Cuypers
  • “Written institutional ethics policies on euthanasia: an empirical-based organizational-ethical framework” by Joke Lemiengre, et al.
  • “Diagnosing mental disorders and saving the normal” by Fredrik Svenaeus
  • “Empathy’s blind spot” by Jan Slaby
  • “Empathy as a necessary condition of phronesis: a line of thought for medical ethics” by Fredrik Svenaeu

House Calls Are Making a Comebak

(New York Times) – A relic from the medical past — the house call — is returning to favor as part of some hospitals’ palliative care programs, which are sending teams of physicians, nurses, social workers, chaplains and other workers to patients’ homes after they are discharged. The goal is twofold: to provide better treatment and to cut costs.

April 21, 2014

Who Provides End-of-Life Care in Care Homes?

(Nursing Times) – A study looked at the responsibility for end-of-life care in care homes without nursing staff. It highlighted that formal carers need support to care for frail older people. Most care homes in England do not have nurses on site and instead rely on visits from GPs and district nurses for primary care and referral to specialist services. It is often unclear whether responsibility for the provision of end-of-life care rests with the care home staff or external health professionals. In addition, identifying which care home residents are likely to die imminently and, as such, should be approached about end-of-life care can be difficult.

April 16, 2014

PET Scans Offer Clues on Vegetative States

(New York Times) – A new study has found that PET scans may help answer these wrenching questions. It found that a significant number of people labeled vegetative had received an incorrect diagnosis and actually had some degree of consciousness and the potential to improve. Previous studies using electroencephalogram machines and M.R.I. scanners have also found signs of consciousness in supposedly vegetative patients.

The Changing Legal Climate for Physician Aid in Dying

(JAMA) – While once widely rejected as a health care option, physician aid in dying is receiving increased recognition as a response to the suffering of patients at the end of life. With aid in dying, a physician writes a prescription for life-ending medication for an eligible patient. Following the recommendation of the American Public Health Association, the term aid in dying rather than “assisted suicide” is used to describe the practice. In this Viewpoint, we describe the changing legal climate for physician aid in dying occurring in several states.

April 11, 2014

Deconstructing Dignity: A Critique of the Right-to-Die Debate, by Scott Cutler Shershow

(The Times Higher Education) – This is a highly topical book, in view of the intense debates taking place in many countries about the possible legalisation of assisted suicide and euthanasia (for example in Canada and France) or the modification of existing laws (for example in Belgium, where the euthanasia law was recently extended to minors). However, its title is slightly misleading: although Scott Cutler Shershow devotes a lot of attention to suicide, this analysis is insufficiently used as a starting point for discussing assisted suicide and voluntary euthanasia. The discussion on euthanasia is limited to involuntary euthanasia as practised, for example, by the Nazis.

Event: Islamic Bioethics and End-of-Life Care: A Practical Workshop

The Initiative on Islam and Medicine, TAQUA Academy, and The MacLean Center for Medical Ethics at the University of Chicago
Islamic Bioethics Workshop
TAQUA Academy
Plano, Texas
Saturday, May 17 9AM to 2PM

See here for more information.

April 10, 2014

A ‘Code Death’ for Dying Patients

(New York Times) – But in this age of technological wizardry, doctors have been taught that they must do everything possible to stave off death. We refuse to wait passively for a last breath, and instead pump air into dying bodies in our own ritual of life-prolongation. Like a midwife slapping life into a newborn baby, doctors now try to punch death out of a dying patient. There is neither acknowledgement of nor preparation for this vital existential moment, which arrives, often unexpected, always unaccepted, in a flurry of panicked activity and distress.

April 8, 2014

Cognitive Impairment Common among Community and Nursing-Home Resident Elderly

(Medical Xpress) – More than 70% of elderly Medicare beneficiaries experience cognitive impairment or severe dementia near the end-of-life and may need surrogate decision makers for healthcare decisions. Advance care planning for older adults with dementia may be particularly important for individuals who do not reside in a nursing home or a long-term care facility, according to an article published in the April issue of Health Affairs.

New Documentary Opens Conversation about Death

(The Globe and Mail) – “My name is Cindy Cowan. I have late-stage ovarian cancer and I would like to have the choice in how I end my life.” Those words are spoken early in The Trouble with Dying (Vision TV, 10 p.m.), a terrific, thought-provoking new documentary about assisted suicide. Vision calls it “hard-hitting.” It is also fair and moving and guaranteed to make you think and rethink your impressions about the issue.

April 7, 2014

Teacher Died at Dignitas Because She Couldn’t Bear Modern Life: Healthy Spinster’s Despair at Fast Food, Email and Lack of Humanity

(Daily Mail) – A retired art teacher committed suicide at the Dignitas clinic in Switzerland after she grew weary of the pace of modern life and how technology was changing society. The 89-year-old felt that her failing health, as well as her belief that people were becoming ‘robots’ attached to their gadgets, gave her little reason to live. The woman, who wanted to be known only as Anne, had suffered from worsening health in recent years, but was neither terminally ill nor disabled.

April 4, 2014

The Hospital-Dependent Patient

(New York Times) – Hospital-dependent patients are those who, a generation ago, were doomed to die. Now they are being saved. But they are not like the so-called hot spotters, a group of patients more commonly associated with frequent re-admissions who return to the hospital because of inadequate follow-up care, failure to take prescriptions correctly or difficult socioeconomic circumstances. Instead, hospital-dependent patients come back because they are so fragile, their grasp on health so tenuous, that they easily “decompensate,” or deteriorate under stress, when not in the hospital.

March 31, 2014

Hospital Trusts Are ‘Fiddling’ Patient Mortality Data, Claims Report

(Nursing Times) – The way hospitals record patient deaths could be covering up poor treatment and costing lives, claims a new report from data analysts. Figures show a dramatic rise in the number of people recorded as needing “palliative care” at the end of their lives, with some hospitals saying more than 35% of their patients die this way. Healthcare analysts Dr Foster claim in their report that hospitals could be hiding the fact patients were admitted for treatment which then failed.

March 28, 2014

Fictional Plotlines and Real Assisted Suicide

(The Atlantic) – The introduction of complex issues into television plots is both a driver and a reflection of cultural shifts. Once a subject gets widespread treatment in scripts, the popular conversation can take on a new urgency, giving people a common vocabulary and a common set of feelings about the characters they’ve come to care about. Now when we talk about aid in dying for those with unbearable suffering—which is legal, with certain restrictions, in five states, with legislation pending in seven more—we can think of Beadie on Girls.

NIHSeniorHealth.gov Offers Comprehensive Information on End of Life

(NIH.gov) – A new Web resource from the National Institutes of Health is aimed at helping people address a sensitive subject—the end of life. The latest addition to NIHSeniorHealth, the health and wellness website for older adults, the End of Life module provides visitors with information about the most common issues faced by the dying and their caregivers.

March 26, 2014

Hospices Can Support the Needs of the UK’s Ageing Population

(The Guardian) – Demand for high-quality palliative and end-of-life care is expected to surge in the next few decades, driven by the UK’s fast-ageing population. More people are living well into their 80s and beyond, many with multiple, complex health conditions. The number of people aged 85 and over is expected to double in the next 20 years. In addition, more young people with life-shortening conditions are living for longer. These demographic changes present huge challenges for all involved in planning and delivering end-of-life care.

March 20, 2014

5 Myths about Hospice Care

(Fox News) – My new book, Changing the Way We Die, co-authored by Sheila Himmel, lifts hospice out of the shadows. We explore its compassionate, holistic approach to end-of-life care through the stories of real patients like Rusty Hammer, their families and their doctors. At its best, hospice is more than a way to relieve the suffering of dying — it is a way to live.

March 18, 2014

Event: Center for Ethics Regional Clinical Ethics Symposium

Center for Ethics
MedStar Washington Hospital Center
Third Annual Regional Clinical Ethics Symposium
True Auditorium
April 21, 2014
Washington, D.C.

See here for registration information.

 

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