March 6, 2014
Dementia death toll may be worse than cancer
(The Telegraph) – The number of people dying from dementia has being vastly underestimated with the disease potentially responsible for more deaths than cancer and heart disease combined, new research suggests. A study from the US has found that Alzheimer’s and dementia is widely under-reported on death certificates and medical records.
Chemotherapy in last months of life associated with increased risk of dying away from home
(Eurekalert) – The use of chemotherapy in terminally-ill cancer patients in the last months of life is associated with increased risk of undergoing resuscitation and dying in an intensive care unit, suggests a paper published on bmj.com today. The researchers suggest that end-of-life discussions may be particularly important for patients receiving chemotherapy and suggest that caregivers should ensure that patients are aware of their prognosis, likely outcomes of treatment and that their choices are aligned with their end-of-life values.
‘How We Die’ author Nuland dies in Conn. at age 83
(ABC News) – Dr. Sherwin Nuland, a medical ethicist who opposed assisted suicide and wrote an award-winning book about death called “How We Die,” has died at age 83. He died of prostate cancer on Monday at his home in Hamden, said his daughter Amelia Nuland, who recalled how he told her he wasn’t ready for death because he loved life.
March 4, 2014
LSD, reconsidered for therapy
(New York Times) – On Tuesday, The Journal of Nervous and Mental Disease is posting online results from the first controlled trial of LSD in more than 40 years. The study, conducted in the office of a Swiss psychiatrist near Bern, tested the effects of the drug as a complement to talk therapy for 12 people nearing the end of life, including Peter. Most of the subjects had terminal cancer, and several died within a year after the trial — but not before having a mental adventure that appeared to have eased the existential gloom of their last days.
Differences in care at for-profit hospices
(New York Times) – People who pay attention to hospice care, so often a godsend for the dying and their families, have noticed and wondered about two trends in recent years: 1) What began as a grass-roots movement to improve end-of-life care is becoming a business. In 1990, only 5 percent of hospices were for-profit operations; by last year, they dominated the industry, representing 63 percent of hospices. 2) We’ve also seen that hospice patients are increasingly likely to be “disenrolled” before they die.
Lifesaving implants complicate end-of-life care
(The Boston Globe) – More than a decade has passed, but Nathan Goldstein, then a medical resident at Mount Sinai Hospital in New York City, still remembers it clearly. A man with terminal lung cancer had planned to die at home with hospice care. Instead, the man was lying on a stretcher in the busy emergency room. Every few minutes, his heart received a shock from his internal defibrillator, preventing his heart from stopping.
How can we reduce end-of-life health-care costs?
(The Wall Street Journal) – Balancing cost, care and quality of life near death remains a puzzle for policy makers, practitioners, and of course, patients and their families. With this difficult calculus in mind, we asked The Experts: How can we reduce end-of-life health-care costs? This discussion relates to the latest Health Care Report and formed the basis of a discussion on The Experts blog on Feb. 26 and 27.
February 28, 2014
Miss. man declared dead, wakes up in body bag at funeral home
(ABC News) – A Mississippi man woke up in a body bag as funeral home workers prepared to embalm him, ABC affiliate WAPT reported. Walter Williams, 78, of Lexington, Miss., appeared to have died at his home Wednesday night. The coroner came to the house and pronounced him dead at 9 p.m.
February 27, 2014
‘Stop medicating elderly and let them die naturally’
(The Telegraph) – Doctors should stop prescribing statins and blood pressure drugs to over 80s because they have little effect and many older people would rather be allowed to die naturally, a health expert has warned. More than two million people over 80 in Britain are currently prescribed pills to prevent strokes and heart attacks with many drugs causing debilitating side-effects. Dr Kit Byatt, a specialist in geriatric medicine at The County Hospital, Hereford, claims many older people ‘see death as the next natural event’ and do not want the burden of medication.
Pathway ‘improves nurse confidence in palliative care’
(Nursing Times) – A practice-based educational pathway has been found to improve nurses’ confidence in delivering end-of-life care to patients. The pathway involved assigning a mentor from a specialist palliative care team to community and district nurses from South Tyneside NHS Foundation Trust. The scheme focused on four care areas: communication skills; advanced care planning; assessment and care planning; and symptom management, maintaining comfort and wellbeing.
February 25, 2014
Man walks free after attempting to kill mother
(Independent) – A 47-year-old Waterford man has been given a suspended three-year sentence for attempting to murder his elderly mother in an attempted mercy killing, after the judge ruled that his motivation was entirely compassionate. Veronica (Vera) Vollrath (83) was pronounced dead on January 9, 2012 at Killure Bridge Nursing Home, Killure, Co Waterford. Her death was expected but her son admitted holding a pillow over her face while keeping vigil by her death bed, and the Austrian resident was charged with her murder.
Nurses who completed practice-based educational pathway report greater confidence in end of life care
(News-Medical) – District and community nurses who completed a practice-based educational pathway reported greater confidence in delivering palliative and end of life care to patients. Nurses working in these roles said communication was their main area of concern in relation to end of life care but this increased significantly during the project, due to interaction with colleagues experienced in this area.
A New Edition of Bioethics is Available
Bioethics (Volume 28, No. 3, March 2014) is now available online by subscription only.
- “2014 International Bioethics Forum Between UK and China and the Professional Development of Bioethics in China” by Li EN-Chang, et al.
- “Living Organ Procurement from the Mentally Incompetent: The Need for More Appropriate Guidelines” by Kristof Van Assche, et al.
- “Are Bans on Kidney Sales Unjustifiably Paternalistic?” by Erik Malmqvist
- “Equity Under the Knife: Justice and Evidence in Surgery” by Wendy Rogers, et al.
- “A Costly Separation Between Withdrawing and Withholding Treatment in Intensive Care” by Dominic Wilkinson and Julian Savulescu
- “Are Phase 1 Trials Therapeutic? Risk, Ethics, and Division of Labor” by James A. Anderson and Jonathan Kimmelman
- “The Nocebo Effect of Informed Consent” by Shlomo Cohen
February 24, 2014
Two year old boy to inherit 11 frozen embryos
(Harvard) – A new twist on frozen embryo litigation is now before a Dallas probate court facing what to do with 11 frozen embryos after the parents were murdered. They left no will and gave no instructions to the fertility clinic for disposition if they both died. Under the Texas intestacy statute the only heir is a two year old boy. The Master in Chancery appointed by the Probate Court has recommended that the embryos be maintained by the clinic until the two year old heir is 18, at which time he would acquire all rights to their disposition.
February 21, 2014
A New Edition of Medical Law Review is Available
Medical Law Review (Volume 22, No. 1, Winter 2014) is now available online by subscription only.
- “Refusal of Emergency Caesarean Section in Ireland: A Relational Approach” by Katherine Wade
- “Does Withdrawing Life-Sustaining Treatment Cause Death or Allow the Patient to Die?” by Andrew McGee
- “Autonomy in the Medic-legal Courtroom: A Principle Fit for Purpose?” by C. Foster
- “Can I Access My Personal Genome? The Current Legal Position in the UK” by Jane Kaye, et al.
- “Existential Suffering and the Extent of the Right to Physician-Assisted Suicide in Switzerland” by Isra Black
- “Anorexia Nervosa, Best Interests, and the Patient’s Human Right to ‘A Wholesale Overwhelming of Her Autonomy’” by John Coggon
Mother of brain-dead Oakland girl says she has ‘hope’
(ABC News) – Weeks after a brain-dead 13-year-old girl was moved to an undisclosed facility following a legal fight between the girl’s family and hospital, her mother is speaking out about their experience and says she has “hope” for her daughter. Nailah Wakfield, who fought to keep her brain-dead daughter Jahi McMath on life support, posted a letter on Facebook to thank supporters and to give an update on her daughter’s condition.
February 20, 2014
A New Edition of Journal of Medical Ethics is Available
Journal of Medical Ethics (Volume 40, No. 3, March 2014) is now available online by subscription only.
- “Responding to complexity” by Kenneth Boyd
- “Imposing options on people in poverty: the harm of a live donor organ market” by Simon Rippon
- “Organ sales and paternalism” by Gerald Dworkin
- “Live liver donation, ethics and practitioners: ‘I am between the two and if I do not feel comfortable about this situation, I cannot proceed’” by Elin H Thomas, et al.
- “What ethical and legal principles should guide the genotyping of children as part of a personalised screening programme for common cancer?” by Alison Elizabeth Hall, et al.
- “Disclosure ‘downunder’: misadventures in Australian genetic privacy law” by Wendy Bonython and Bruce Arnold
- “Attitudes towards euthanasia in Iran: the role of altruism” by Naser Aghababaei
- “Discovering misattributed paternity in genetic counselling: different ethical perspectives in two countries” by Pamela Tozzo, et al.
- “In need of remedy: US policy for compensating injured research participants” by Elizabeth R Pike
- “The acceptability among young Hindus and Muslims of actively ending the lives of newborns with genetic defects” by Shanmukh Kamble, et al.
- “Cultural explanations and clinical ethics: active euthanasia in neonatology” by Ayesha Ahmad
- “The best interests of persistently vegetative patients: to die rather that to live?” by Tak Kwong Chan and George Lim Tipoe
The lies that doctors and patients tell
(New York Times) – The doctor-patient relationship is ideally an intimate partnership where information is exchanged openly and honestly. That is seldom the reality, however. Deception in the doctor-patient relationship is more common than we’d like to believe. Deception is a charged word. It encapsulates precisely what we dread most in a doctor-patient relationship, and yet it is there in medicine, and it often runs both ways.
Cancer study shows earlier palliative care improves quality of life, patient satisfaction
(Medical Xpress) – Results of the first clinical study to assess the impact of providing early outpatient palliative care versus standard oncology care in a wide range of advanced cancers show that earlier care improved quality of life and patient satisfaction. The four-year study involved 461 patients at 24 medical oncology clinics at Princess Margaret Cancer Centre, University Health Network (UHN) with advanced lung, gastrointestinal, genitourinary, breast and gynecologic cancers.
Event: Preparation: How to Assist with Advance Care Planning
The Center for Ethics at MedStar Washington Hospital Center
Preparation: How to Assist with Advance Care Planning
May 9th, 2014
See here for more information.
February 19, 2014
Study: Bring home-based hospice techniques to hospital
(Nurse.com) – Using home-based hospice practices for terminally ill, hospitalized patients could reduce suffering and improve end-of-life care, according to a study. The study, published Jan. 21 on the website of the Journal of General Internal Medicine, was described as the first to show that palliative care techniques usually used in a home setting can affect end-of-life care for those who die in a hospital.