Jahi McMath "Doing Well" 10 Months after Death

The Terri Schiavo Life & Hope Network just released this update on Jahi McMath."We are often asked and receive frequent emails from supporters wanting to know about Jahi McMath, so I wanted to give a quick update. It has been almost 10 months since Jahi was declared 'brain dead' by the State of California. As in any case with someone who has experienced a profound brain injury, progress can be very slow. Nonetheless, Jahi is doing well and continues to show signs she is improving. We remain in touch with the family and I am sure they are grateful...

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Judge Orders Baby Off Life Support, Despite Mom's Objections

Today, Ms Justice Russell (Family Division, UK High Court) ruled that a one-year-old boy with brain damage should be taken off a life-support machine despite his parents' pleas to keep him alive.  (Daily Mail 1)CliniciansThe NHS foundation trust which runs the hospital where the youngster is being cared for brought the petition. The boy was born prematurely by emergency Cesarean section in 'poor condition' and he required...

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Festering Mistrust over Brain Death

I was disappointed to see this newsletter article from the Life Issues Institute and the Terri Schiavo Life & Hope Network titled "The Market for Brain Death."  The primary focus seems to be on aid in dying, particularly involuntary or non-voluntary aid in dying.  But both the title and the article go on to suggest that unilateral judgments regarding life-sustaining treatment or aid in dying, "may lie behind what seems to be an increase in the 'brain death' diagnosis."As I recently noted, treatment disputes after diagnosis of...

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Congress Urges CMS to Adequately Reimburse Physicians for Advance Care Planning

This week, 34 Members of the House of Representatives, sent a letter to Centers for Medicare & Medicaid Services (CMS) Administrator, Marilyn Tavenner, to adopt recommendations that would adequately reimburse Medicare providers for having voluntary discussions about end-of-life care and planning with patients.Currently, the time doctors spend having discussions with their patients about end-of-life care and planning is not reimbursed...

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Australian Medical Association Position Statement on Medical Futility

Earlier this month, the Australian Medical Association released a new "Position Statement on End of Life Care and Advance Care Planning 2014." The statement outlines policy on issues such as medical futility, decision making capacity, advance care planning, artificial nutrition and hydration, bereavement, workforce, and community awareness.Futile Treatment is defined as "Treatment that no longer provides a benefit to a patient or treatment where...

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Denying Others the Right to Die (cartoon)

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POLST - New US Map of POLST Paradigm Programs

The National POLST Paradigm Task Force has updated its national map of POLST programs.  Here are the definitions of the different statuses.  Mature status - the highest level of endorsement by the NPPTF is reserved solely for states with statewide POLST programs that, among other requirements are the standard preferred method of advance care planning for persons with advanced illness or frailty. Mature POLST programs are used by 50%...

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Hospice Ethics Policy and Practice in Palliative Care

Oxford University Press has just published Hospice Ethics: Policy and Practice in Palliative Care.  Hospice is one of the fastest-growing segments of the U.S. healthcare system, a trend that is expected to accelerate as the median age of the population continues to rise over the next three decades. Despite over forty percent of the population now dying while on hospice care, very little has been published on the ethical opportunities and challenges...

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Health Care Reform Implementation in Minnesota: Mission Advanced But Not Accomplished

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Careers & Pro Bono Opportunities in Bioethics & Law

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Both Sides Now: Living with Dying: An Immersive Arts Experience

Puppetry, theater, visual arts, and more.  A very cool arts experience is happening this weekend in Singapore called Both Sides Now.  The "immersive arts experience" provides the opportunity for the living to encounter dying. Organizers hope to normalise conversations about end-of-life issues by taking this conversation to public spaces. Through interacting with the various artworks, Both Sides Now invites participants to reflect on...

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Ethical Issues in End-of-Life Care: MacLean Center Interdisciplinary Faculty Seminar Series

Check out this amazing roster of nearly 30 world class seminars on end-of-life issues in the MacLean Center's 2014-2015 Interdisciplinary Faculty Seminar Series.In the past 50 years, medicine has developed new and unprecedented technologies like breathing machines and dialysis that can prevent or delay death. These technologies have changed how people die, where people die, and physicians’ responsibilities to dying patients. During these 50...

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Better to Be Dead than Disabled?

The disability rights group Not Dead Yet is leading a three-day protest vigil against the World Federation of Right to Die Societies which is holding a meeting that I am attending in Chicago.  Disability rights advocates have certainly expressed some valid concerns about the expansion of options to hasten death.  Legislators, regulators, and clinicians should seriously grapple with concerns like risks of bias and coercion.  Unfortunately,...

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Improving Quality and Honoring Individual Preferences Near the End of Life (IOM 2014)

Yesterday, the Institute of Medicine released its 500-page report, Improving Quality and Honoring Individual Preferences Near the End of Life.A substantial body of evidence shows that broad improvements to end-of-life care are within reach. In Dying in America, a committee of experts finds that improving the quality and availability of medical and social services for patients and their families could not only enhance quality of life through the end...

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Prevalence of Non-Beneficial ICU Treatment

The Ventura County Star has a new story and a poll on medical futility.  In addition to recounting the widely discussed UCLA research, health care reporter Tom Kisken interviews clinicians at other Southern California hospitals."I think it happens at every hospital in the United States." -- Dr. Hannah Grossman, chief medical officer at Los Robles Hospital & Medical Center in Thousand Oaks."I wouldn't say it happens every day. . . .  I would say we might have one or two patients a week where it might be futile." -- Dr. David...

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International Resource Library on Adult Guardianship

The 3rd World Congress on Adult Guardianship recently convened in Washington, DC. One of the goals of this Congress was to form an online International Resource Library on Adult Guardianship.  That resource is now available here.The organizers are also looking for more submissions, including papers, brochures, manuals, handbooks and more, are welcome if they would be of help to others.  Submissions may be made by emailing info@nationalguardianshipnetwork.org...

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Emotional, Religious Reasons to Keep Grandson in PVS on Life Support

This sad story in the Chicago Tribune powerfully illustrates why one grandmother could not consent to comfort care only for her grandson.  The grandmother's daughter had been shot by a gang member while still pregnant.  "To Jefferson, the baby looked just like her daughter — her face, her color, her hands. But doctors told her [the baby] would remain in a persistent vegetative state, unable to see, hear or breathe on his own."  Clinicians "urged her to remove him from life support, telling her his condition...

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CALL FOR PAPERS Aging, Law, & Society Critical Research Network

CALL FOR PAPERSAging,Law, & Society Critical Research NetworkLawand Society Association Annual MeetingSeattle,May 28 – May 31, 2015The Aging, Law, and Society Critical ResearchNetwork (CRN) invites scholars to participate in a multi-event workshopsponsored by the CRN as part of the Law and Society Association’s 2014 AnnualMeeting.  The Aging, Law & SocietyCRN brings together scholars from across disciplines to share research andideas about the relationship between law and aging, including how the lawresponds the needs of persons as...

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Minnesota Maintains 100 Percent Rate for Advance Care Planning

In study after study after study, researchers bemoanpersistently mediocre rates of advance care planning.  So, I was delighted to hear the Medical Director or Honoring Choices Minnesota, Ken Gephart, announce at a recent conference that the "effective" completion rate of advance care planning in Minnesota is 100%.What he meant is that medical treatment decisions have been made for every Minnesotan (and every other American too) should they...

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Vincent Lambert - Treatment Pending European Court of Human Rights

The slow and cumbersome nature of litigation often means that the status quo is preserved for a long time, until judgment.  In the context of end-of-life medical treatment, this usually means that the patient's biological existence is perpetuated for months or even years unless or until the court says that physiological support can stop.  The family of Vincent Lambert is fighting about his proper treatment pending a ruling from the European Court of Human Rights either affirming or reversing the French Council of Sta...

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Law and Bioethics Career Panel

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Bad Medical Language: "Failure to Die" & "GOMER"

Brian Goldman recently published The Secret Language of Doctors.  In 330 pages, Goldman exposes the clandestine phrases that doctors use to describe patients, situations and even colleagues they detest. This book reveals modern medical culture at its best and all too often at its worst.Specifically, chapter five is titled "Failure to Die."  This tragic term and the related term "GOMER" is discussed in a brief promotional video...

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In re A.P. - Maybe Moot before Maine Supreme Court Can Decide DHHS Right to Direct DNR over Mother Trask's Objections

Last weekend, I quickly summarized a futility case now pending before the Supreme Court of Maine:  In re A.P. [Aleah Peaslee], KEN-14-192.This is not a traditional futility conflict, because it is not between the patient's surrogate and the patient's healthcare providers.  Instead, the dispute is between a baby's mother (Virginia Trask) and the Maine Department of Health and Human Services who has taken (temporary) custody of the child.Because...

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Disability Groups & Aid in Dying

Not surprisingly, a number of disability groups have expressed concern to the Disability Rights Legal Center about its recent hiring of Kathryn Tucker.  For example:  "We wish to engage in dialogue with you about the serious concerns we have over Ms. Tucker’s work in her previous position at Compassion & Choices that has placed members of the disability community in significant danger."  I really hope that this dialogue happens.  I hope that it will be productive in softening disability groups opposition to aid in dying....

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BBC Dramatization of Assisted Suicide - "The Dilemma"

BBC One has a new show called The Secrets that ran five episodes last week.  The first was called "The Dilemma" and concerns a daughter helping her mother hasten death.  Here is the abstract:"Pippa is a vet working in a practice based in north London. She is married to Shaun, a tree surgeon running his own outfit, and they are expecting their first child. She has been a vet for the best part of a decade and is beginning to struggle with...

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Top 20 Medical Journals in the World

Google Scholar Metrics provide an easy way for authors to quickly gauge the visibility and influence of recent articles in scholarly publications. Scholar Metrics summarize recent citations to many publications, to help authors as they consider where to publish their new research.  Google Scholar identifies the following as the top 20 medical journals based on citations.  I have published in 3 of these.1. The New England Journal of Medicine 2. The Lancet 3. Cell 4. Proceedings of the National Academy of Sciences5. Journal of Clinical...

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Top 20 Bioethics Journals in the World

Google Scholar Metrics provide an easy way for authors to quickly gauge the visibility and influence of recent articles in scholarly publications. Scholar Metrics summarize recent citations to many publications, to help authors as they consider where to publish their new research.  Google Scholar identifies the following as the top 20 bioethics journals based on citations.  I have published in 3 of these.1. Journal of Medical Ethics 2. The American Journal of Bioethics 3. Nursing Ethics 4. Bioethics 5. Hastings Center Report 6. Journal...

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Palliative Care - Free Webinar Series

The MJHS Institute for Innovation in Palliative Care providing a free webinar series for clinicians and researchers working in palliative care.The first one is on September 23:  "Palliative Care: Changing the Health Care Landscape Through Emerging Models."  Another webinar follows every other we...

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West Virginia e-Directive Registry - Model for Other States

West Virginia has the most comprehensive registry in the United States.  It includes POST (Physician Orders for Scope of Treatment), both types of advance directives, and DNR cards.A registry is important because even when individuals do advance care planning and record their preferences regarding treatment or healthcare agents, those documents are often not available at the time needed.  The WV e-Directive Registry provides 24/7...

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7th Annual Pediatric Bioethics Conference

On November 7, 2014, Wolfson Children’s Hospital, in partnership with the University of North Florida and the Florida Bioethics Network, presents the Seventh Annual Pediatric Bioethics Conference.Welcoming Remarks Alissa Hurwitz Swota, PhDUniversity of North Florida and Wolfson Children’s Hospital, Jacksonville, FLWolfson Lecture: Ethical Dilemmas in Pediatric Nursing AdministrationVeronica Scott-Fulton, DNP, MPH, RN, NEA-BCVice President,...

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