Decision Aids for Advance Care Planning: An Overview of the State of the Science

Just published in the Annals of Internal Medicine (available for free): "Decision Aids for Advance Care Planning: An Overview of the State of the Science."This review, commissioned as a technical brief by the Agency for Healthcare Research and Quality Effective Health Care Program, provides a broad overview of current use of and research related to decision aids for adult advance care planning.&nb...

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The End of End-of-Life Law

Check out this new article by UVA professor Lois Shepherd "The End of End-of-Life Law."As the title suggests, Shepherd's article argues that questions about medical care at the end of life should be approached like other important questions about medical care—with consideration to patients’ wishes, values, interests, and relationships, and without special laws, special burdens of proof, or unique requirements for documentation....

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New NINR Video Focuses on Preparing for the End of Life

A new video, co-produced by the National Institute of Nursing Research seeks to help people by answering one of life’s most sensitive questions: how can a person best prepare for the end of life? Developed to highlight content from NINR’s recently released End of Life module, the video stresses the importance of learning about end of life care options, which focus on comfort and quality of life.NINR Director Dr. Patricia A. Grady, the featured speaker in the video, explains “A person can best prepare for the end of life by becoming informed....

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Even after Tracey Decision, Unilateral & Covert DNR Orders Continue

Last month, the UK Court of Appeal confirmed that while clinicians do not need family consent to write a DNR order, they must at least consult with families before writing a DNR order on an incapacitated patient.  But a court decision does not change custom and practice overnight.  Garry Whitlam, who has a terminal liver illness, was put into an induced coma at Weston General Hospital  after failing to respond to treatment.  While...

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Death & Medical Treatment - New Symposium

The August 2014 issue of the American Journal of Bioethics includes a symposium of over 20 articles on the intersection of medical treatment and death.  I was unable to contribute to this issue because of competing manuscript deadlines this spring.  But I will be participating in a similar symposium forthcoming in the Journal of Clinical Ethics 25(3) focused specifically on death determined by neurological criteria.  My piece focuses on new statutory, regulatory, and judicial developments.  Another article focuses...

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Kim Teske - Compelling Story of VSED

The Globe & Mail has a very extensive story on Kim Teske and her use of VSED to die on her own terms.Teske had Huntington’s, an incurable genetic disease that combines aspects of Parkinson’s, Alzheimer’s and schizophrenia. She feared that, if she did not act now, she will end her days in an institution with strangers pushing mush into her mouth and hosing her down after she defecates.  So, Teske stopped eating and drinking. Around...

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Wake Up to Dying Project

The Wake Up to Dying Project is an awareness and action campaign that encourages people to think and to talk about dying.  The organizers do this by gathering and sharing stories about death, dying, and life. They also do this through art and hands-on opportunities to explore these important subjects.The organizers believe that if we consider this difficult subject more purposefully we will be more prepared, practically and emotionally, to face this shared human experience. We might find ourselves more willing to participate in the dying process...

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Do Oregon and North Dakota Healthcare Surrogates Perform Better?

In most states an individual can appoint a healthcare agent not only without the consent of the agent but also without even discussing the appointment with the agent.  In fact, many healthcare surrogates fulfill the role of substitute decision maker with neither an understanding of the role nor an understanding of the patient's wishes.But in Oregon and North Dakota healthcare agents must accept the appointment in writing.  (Ore. Rev. Stat. 127.525; N.D. Code 23-06.5-06)  Ideally this requirement would apprise the agent of their duties....

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Pope Cited by NRLC before Senate Judiciary Committee

Many of my (pro-liberty) positions on end-of-life medical treatment issues do not endear me to the National Right to Life Committee.  But I do aim to produce careful and circumspect scholarship.  Consequently, I was pleased to see the president of NRLC cite me in her testimony before the U.S. Senate Judiciary Committee this week.   &nb...

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Only a Third Who Express a Preference to Die at Home, Actually Die at Home

There is a well-known discrepancy between people's preferences to die at home and their likelihood to actually die at home.  This has already been measured several times.  Now, there is additional confirmation.Last week, the UK Office of National Statistics released a statistical bulletin: National Survey of Bereaved People (VOICES), 2013.  The reports finds that only one third of people (35%) who express a preference to...

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Rationing Is Not a Four-Letter Word

Philip M. Rosoff is a practicing physician and Professor of Pediatrics and Medicine at Duke University Medical Center, where he is also a member scholar of the Trent Center for Bioethics, Humanities, and History of Medicine, and Director of Clinical Ethics at Duke University Hospital.He has just published Rationing Is Not a Four-Letter Word with MIT Press.  I like this book's thesis and explored it (a little) in some posts like "Top 10...

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Defending Advance VSED - Hasten Death by Dehydration

VSED has been getting a lot of attention lately.  NPR radio host Diane Rehm discussed her husband's use of VSED to hasten his death.  Sir Chris Woodhead discussed VSED in the ongoing assisted dying debate that will reach the House of Lords on Friday.  And the Tampa Bay Times just published a 1000 word article.  But I want to respond to a rather lengthy attack on me specifically.  Last Thursday, Lydia McGrew published this 5-page attack on advance VSED.   First, let me clarify that I agree with McGrew: "The...

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Call for Papers - AALS Section on Law, Medicine & Health Care Works-in-Progress for New Teachers

Call forPapersAALS Sectionon Law, Medicine & Health CareWorks-in-Progressfor New Law School TeachersAALS AnnualMeeting, Washington, DCSaturday,January 3, 2015  TheAALS Section on Law, Medicine and Health Care is pleased to announce a Call forPapers for a special Works-in-Progress for New Law School Teachers Program.  The Section will run the Program from 5:15 to6:30 p.m. on Saturday, January 3, at the AALS 2015 Annual Meeting in Washington,DC.Thisprogram will bring together junior and senior health law scholars for a livelydiscussion...

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Funerals - Posing the Dead as Living

I like the idea of remembering people as they were.  But this funeral posing also seems to feed into strong death-denying currents in our socie...

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Kentucky Judge to Decide on Hospital Treatment for Dead 2-Month Old Isaac Lopez

On Monday, July 14, Judge McKay Chauvin (Jefferson County Circuit Court, Kentucky) will determine whether Norton Healthcare and Kosair Children's Hospital must continue organ-sustaining interventions for two-month-old Isaac Lopez.  His father is accused of criminal abuse that resulted in Isaac's death. (WD...

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20th World Federation Conference of Right to Die Societies

Check out the schedule of events for the 20th World Federation Conference of Right to Die Societies in Chicago in Septemb...

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International Conference on End of Life: Law, Ethics, Policy, and Practice

Check out this amazing program, next month, for the International Conference on End of Life: Law, Ethics, Policy, and Practi...

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Nominate the Medical Futility Blog

If you read this blog, I could use your help.  The American Bar Association is starting to consider which law blogs will make its 8th Annual Blawg 100.  They are soliciting nominations of blogs that you read regularly and think lawyers should know about. Submit nominations and read more details about submitting a Blawg Amici, or friend-of-the-blawg brief, here.  Friend-of-the-blawg briefs are due no later than 5 p.m. ET on Friday,...

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Moral Distress Education Project

Medical futility disputes have been repeatedly measured as one of the biggest causes of moral distress, especially among nurses.The University of Kentucky has launched a completely free continuing education version of The Moral Distress Education Project. The program functions as a self-guided documentary that provides up to 2.0 hours credits. Unidentified or unresolved moral distress leads to retention problems; horizontal violence; and patient-care gaps. By the end of this program learners will understand the root causes of moral distress...

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Understanding Cultural Diversity at End-of-Life - New eBook

Passare, an end-of-life planning company, has released its fifteenth eBook titled "Understanding Cultural Diversity at End-of-Life."  In this book, Passare shares guidance to help you explore and understand how different cultures observe and honor end-of-life. &nb...

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Palliative Care - An Illustrated Story

Check out this new 5 page illustrated story about Palliative Care by Isabella Bannerman.Here is just the first of the 5 pages. &nb...

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Louisville Judge Orders Kosair Children's Hospital to Continue Ventilating Brain Dead Child

Juan Alejandro Rosales Lopez is behind bars, accused of criminal abuse.  Police contend that Lopez caused his 2-month-old son, Isaac, severe head injuries.  Indeed, the injuries were apparently so severe that Isaac has already been diagnosed as dead.  (WLKY; WHAS; WDRB)Given the diagnosis of death, clinicians at Kosair Children's Hospital understandably want to remove organ-sustaining measures.  But  Jefferson County Circuit...

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POLST Introduces No New Risks

This week, the LA Times published an op-ed opposing POLST.  The writer, Ben Mattlin, concedes that "the attention being given to end-of-life choices is a good sign for those of us who are concerned about patients' rights."  He also concedes that "too many people die in hospitals rather than at home where they'd prefer to be."But Mattlin also argues that "there's no provision to ensure how well informed you are at the time to make such a...

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Global Institute for Psychosocial, Palliative and End-of-Life Care (GIPPEC)

This week, the University of Toronto and the University Health Network (UHN) launched a new institute dedicated to end-of-life issues and the treatment of patients with life-threatening terminal diseases: the Global Institute for Psychosocial, Palliative and End-of-Life Care (GIPPEC).  GIPPEC will have its formal inauguration in October 2014, and will be functioning within the next year. It will include a core staff of about six people, and...

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Ten Common Questions (and Their Answers) on Medical Futility [Video]

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Lawyers & Clinicians: Ethical Obligations to Older Adult Clients & Patients

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Unbefriended Elderly: Making Medical Treatment Decisions for Patients without Surrogates

Call for PapersAALS JointProgramSection on Agingand the Law  ●  Section on Law, Medicine, and Health Care2015 AALS AnnualMeeting in Washington, D.C.January 3, 2015 from3:30 to 5:15 p.m.UnbefriendedElderly:  Making MedicalTreatment Decisions for Patients without SurrogatesTheAALS Section on Aging and the Law and the AALS Section on Law, Medicine, andHealth Care are sponsoring a joint program at the January 2015 AnnualMeeting.  The program will consider manyof the issues faced by elders, doctors, and the health care and social...

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Sad, Sad State of Medical Informed Consent

This photograph "After a Flash Flood, Rancho Mirage" could be a great metaphor for the state of informed consent.  We have lofty, fancy principles that are well-articulated in ethics and in law.  These principles are like the calm and settled state of the car parked by the suburban house.  But very close by, is how informed consent really works. This is like the car that has overturned and fallen into the sinkhole.  The contrast...

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