Vanitas (by Peter Claesz) means "emptiness" - the meaninglessness of earthly life and the transient nature of vani...
Thứ Ba, 30 tháng 6, 2015
Estate Planning In the 21st Century: Seismic Shifts and Predictions for the Future - CFP
Estate Planning in the 21st Century: Seismic Shifts and Predictions for the FutureThe American College of Trust and Estate Counsel (ACTEC Law Journal) announces a Call For Papers on the following topics: Estate planning has radically changed in the last several decades. Statutes such as the Uniform Probate Code and the Uniform Parentage Act altered the presumptive definitions of such terms as "children" and "descendants" to include a much broader range of beneficiaries, including adoptees, out-of-wedlock children, and in...
Ethical Issues at the End of Life - CFP
The Journal of Social Work in End-of-Life & Palliative Care has a CFP for a special thematic issue on ethical issues at the end of li...
Thứ Hai, 29 tháng 6, 2015
Jahi McMath - Children's Hospital Demurrer
Following last week's demurrer by Defendant Rosen, this week, Children's Hospital Oakland filed its own demurrer in the medical malpractice action filed by the family of Jahi McMath. Almost the entire brief is devoted to the question of her status as alive or de...
Judge Strikes California Law that Allowed Nursing Homes to Make Medical Decisions for Unbefriended Residents
I just updated my prior articles on decision making for adult orphans, unbefriended, unrepresented patients without surrogates (forthcoming 26(2) J Clinical Ethics). And then this.A California law allowing nursing homes to make medical decisions on behalf of certain mentally incompetent residents is unconstitutional, a state court ruled this week.The law, which has been in effect more than 20 years, gave nursing homes authority to decide residents’ medical treatment if a doctor determined they were unable to do so and they had no one to represent...
Relics - Film on Assisted Death [EOL in Art 50]
Relics is a 15-minute film about a salesman who tries to sell his miraculous cleaning machine to a sick woman and her skeptical daughter, on the day that the woman asked her daughter to help her end her own life. It's a comedy! Sort of...Relics screened at numerous film festivals in 2014 and won several awards along the way, including an Adrienne Shelly Foundation Award for Best Female Director, second place at Palm Springs International ShortFest, and Finalist at the USA Film Festival. It has now been released onli...
Support Informing Bioethics Policy
This week, I added a Paypal donation button to my website to help cover cost, such as obtaining court documents from PACER and state court websites. input name="encrypted" type="hidden" value="-----BEGIN PKCS7-----MIIHPwYJKoZIhvcNAQcEoIIHMDCCBywCAQExggEwMIIBLAIBADCBlDCBjjELMAkGA1UEBhMCVVMxCzAJBgNVBAgTAkNBMRYwFAYDVQQHEw1Nb3VudGFpbiBWaWV3MRQwEgYDVQQKEwtQYXlQYWwgSW5jLjETMBEGA1UECxQKbGl2ZV9jZXJ0czERMA8GA1UEAxQIbGl2ZV9hcGkxHDAaBgkqhkiG9w0BCQEWDXJlQHBheXBhbC5jb20CAQAwDQYJKoZIhvcNAQEBBQAEgYAJ+yn6dLzi/rXqcAImE79QB9zyoll5GzJdN07I1zsuVsQptYrBdBhkMN1bOfTUM2WMvAfdFRT48cSxDkcQpwOV2NpIyStFfjhI4Rz7cO0Muar79BEGO5Y2ZO/M+r1rDmhEMPRWzIWjE/qeq4ugP8qXvCwV/8Ejty9Xe6q1MwglHjELMAkGBSsOAwIaBQAwgbwGCSqGSIb3DQEHATAUBggqhkiG9w0DBwQIfvv0sfkDm0uAgZhiGnaZeD1hccAuF8wE+5ikb0Zb+a84IP4w2WerF5gkrq2t/JQWdVbkvI9barS8ikPAT8IVu6YVlOZI58ctYSBxsJOhNPaOF+GJ52Egzxy1feD9S4H+Y7S5SQXWmWotXOmA9Rz9KltfcEQ9RsTy6ueTCrjTedno0CK8B8ClQqpX3O7sgYNVPj5PoNB2WmBapNyZmMFD5rsUiaCCA4cwggODMIIC7KADAgECAgEAMA0GCSqGSIb3DQEBBQUAMIGOMQswCQYDVQQGEwJVUzELMAkGA1UECBMCQ0ExFjAUBgNVBAcTDU1vdW50YWluIFZpZXcxFDASBgNVBAoTC1BheVBhbCBJbmMuMRMwEQYDVQQLFApsaXZlX2NlcnRzMREwDwYDVQQDFAhsaXZlX2FwaTEcMBoGCSqGSIb3DQEJARYNcmVAcGF5cGFsLmNvbTAeFw0wNDAyMTMxMDEzMTVaFw0zNTAyMTMxMDEzMTVaMIGOMQswCQYDVQQGEwJVUzELMAkGA1UECBMCQ0ExFjAUBgNVBAcTDU1vdW50YWluIFZpZXcxFDASBgNVBAoTC1BheVBhbCBJbmMuMRMwEQYDVQQLFApsaXZlX2NlcnRzMREwDwYDVQQDFAhsaXZlX2FwaTEcMBoGCSqGSIb3DQEJARYNcmVAcGF5cGFsLmNvbTCBnzANBgkqhkiG9w0BAQEFAAOBjQAwgYkCgYEAwUdO3fxEzEtcnI7ZKZL412XvZPugoni7i7D7prCe0AtaHTc97CYgm7NsAtJyxNLixmhLV8pyIEaiHXWAh8fPKW+R017+EmXrr9EaquPmsVvTywAAE1PMNOKqo2kl4Gxiz9zZqIajOm1fZGWcGS0f5JQ2kBqNbvbg2/Za+GJ/qwUCAwEAAaOB7jCB6zAdBgNVHQ4EFgQUlp98u8ZvF71ZP1LXChvsENZklGswgbsGA1UdIwSBszCBsIAUlp98u8ZvF71ZP1LXChvsENZklGuhgZSkgZEwgY4xCzAJBgNVBAYTAlVTMQswCQYDVQQIEwJDQTEWMBQGA1UEBxMNTW91bnRhaW4gVmlldzEUMBIGA1UEChMLUGF5UGFsIEluYy4xEzARBgNVBAsUCmxpdmVfY2VydHMxETAPBgNVBAMUCGxpdmVfYXBpMRwwGgYJKoZIhvcNAQkBFg1yZUBwYXlwYWwuY29tggEAMAwGA1UdEwQFMAMBAf8wDQYJKoZIhvcNAQEFBQADgYEAgV86VpqAWuXvX6Oro4qJ1tYVIT5DgWpE692Ag422H7yRIr/9j/iKG4Thia/Oflx4TdL+IFJBAyPK9v6zZNZtBgPBynXb048hsP16l2vi0k5Q2JKiPDsEfBhGI+HnxLXEaUWAcVfCsQFvd2A1sxRr67ip5y2wwBelUecP3AjJ+YcxggGaMIIBlgIBATCBlDCBjjELMAkGA1UEBhMCVVMxCzAJBgNVBAgTAkNBMRYwFAYDVQQHEw1Nb3VudGFpbiBWaWV3MRQwEgYDVQQKEwtQYXlQYWwgSW5jLjETMBEGA1UECxQKbGl2ZV9jZXJ0czERMA8GA1UEAxQIbGl2ZV9hcGkxHDAaBgkqhkiG9w0BCQEWDXJlQHBheXBhbC5jb20CAQAwCQYFKw4DAhoFAKBdMBgGCSqGSIb3DQEJAzELBgkqhkiG9w0BBwEwHAYJKoZIhvcNAQkFMQ8XDTE1MDYyOTAwNTAyOVowIwYJKoZIhvcNAQkEMRYEFOEeil9OM1jehP1pICZ48DBUokLvMA0GCSqGSIb3DQEBAQUABIGADkb8T5ubQ8RrtYlbnsJh18D4aFQmvN7gsKy+JKSiVBPOFTud1RYV/uKQHLWVig4OyPFjtocosyx7bZWiFuXIYqJTkd4QEX/AAlwJf4e7aMysRr8lEsa0Bn3PphKsLA2Dm1JneAL7pmJJndRBARl9pS+s3b/wtOfSeK3W4qkaFK8=-----END...
Chủ Nhật, 28 tháng 6, 2015
Heartfelt - Photography of Troubled Births [EOL in Art 49]
Heartfelt is a volunteer organisation of professional photographers from all over Australia dedicated to giving the gift of photographic memories to families that have experienced stillbirths, premature births, or have children with serious and terminal illnesses. &nb...
Thứ Bảy, 27 tháng 6, 2015
Art of Hospice [EOL in Art 48]
Last summer, the Louisiana-Mississippi Hospice and Palliative Care Organization held an Art of Hospice competition. The works help make people more aware of hospice and better understand its benefi...
Thứ Sáu, 26 tháng 6, 2015
No Immunity for Providers Who Treated Patient Contrary to Her Advance Directive
In March 2012, clinicians at Doctors Hospital of Augusta intubated terminally ill 91-year-old Bucilla Stephenson and placed her own mechanical ventilation. This was contrary to Stephenson's advance directive and contrary to the specific directions of her designated healthcare agent (her granddaughter). In May 2013, Stephenson's agent filed a lawsuit alleging that the defendant clinicians caused her grandmother...
Pluralism, Futility, and Thresholds for Treatment in Intensive Care
The annual meeting of the Australasian Association of Bioethics and HealthLaw starts today with a keynote plenary by Dominic Wilkinson: "Pluralism,Futility, and Thresholds for Treatment in Intensive Car...
Thứ Năm, 25 tháng 6, 2015
Hospice Stamp [EOL in Art 46]
In 1999, the U.S. Postal Service issued the Hospice Care Commerative Stamp to help raise awareness about hospice.The stamp was designed by veteran stamp designer Phil Jordan to symbolize life’s journey to its final stage, the stage where Hospice lends its vision for end-of-life care. The Hospice stamp features a large green field in front and a tree beside a while house, with a large yellow and red butterfly flying above.&nb...
SNF Fined $400,000 for Blindly Following the Surrogate
Earlier this week, I wrote about a recent CMS investigation in which a hospital wrongly looked to a surrogate even though the patient still had capacity to make her own healthcare decisions. Today, I summarize a similar case from the DHHS Departmental Appeals Board in which the facility was fine nearly $400,000.NMS Healthcare of Hagerstown is a skilled nursing facility. It confined one of its residents and restricted her access to members...
Thứ Tư, 24 tháng 6, 2015
Aid in Dying - Minnesota
To follow-up on yesterday's Minnesota Public Radio show on MN Senator Chris Eatonaid-in-dying, I collect some relevant resources below.Minnesota is one of nearly 30 states, this year, to consider legislation legalizing aid in dying. Here is a link to the bill, SF 1880, "The Minnesota Compassionate Care Act." Here is some press coverage.The leading organization in the country defending AID is Compassion & Choices. There...
Process of Dying in 6 Paintings [EOL in Art 45]
A Swiss Oncologist shares six paintings by the Swiss painter Ferdinand Hodler (1853-1918) in the Journal of Clinical Oncology (2002; 20:7: 1948-50).Hodler painted his wife before, during, and after her illness. He documented her wasting and eventual extinction without mercy and yet with intense sympathy. He created a series of paintings that force the viewer to face the process of dying.Figure 1, the youth. This portrait in shades of red shows her...
Thứ Ba, 23 tháng 6, 2015
Jahi McMath Malpractice Lawsuit - June 2015 Update
As I blogged here in March 2015, the family of Jahi McMath filed a medical malpractice action against Oakland Children's Hospital and several individual clinicians. Last week, the lead defendant, otolaryngologist Frederick Rosen, filed a demurrer (76-page PDF). Not surprisingly, the demurrer starts by arguing that Jahi "is deceased" and therefore does "not have standing to allege a personal injury claim."Furthermore, anticipating...
Time and Death [EOL in Art 44]
In this terracotta model, Gianlorenzo Bernini (1598-1680) shows Time dominating the skeletal figure of Death. The Victoria & Albert Museum notes that this conveys the message that the passage of time confirms the immortality of the deceased's reputation through fame (or of their soul through redemption). Time raises the coffin out of Death's reach, thus cheating him of his prize. Death appears to emerge from the ground itself, his...
Thứ Hai, 22 tháng 6, 2015
Aid in Dying - Minnesota Public Radio
Join me tomorrow, Tuesday, June 23rd at 9:00, on Minnesota Public Radio. From the producer's notes:Earlier this month, the California Senate approved a physician-assisted suicide bill, allowing some terminally ill patients to receive help in ending their lives. The bill had been stalled for years, in part because the California Medical Association - a group representing California physicians - had always opposed physician-assisted suicide....
Death Listens [EOL in Art 43]
In "Death Listens," Hugo Simberg (1873-1917) depicts Death, personified as a skeleton wearing a black coat, listening with a bowed head as a young man plays the violin. In the background, there is an old woman lying on a bed, pale and apparently sickly. There is a suggestion that Death is there for the old woman, but that he is pausing so the young man, possibly the dying woman's son, can have time to finish his violin playi...
Atul Gawande in Minnesota (Sept. 18, 2015)
I got my ticket to see Atul Gawande in Saint Paul, Minnesota on September 18. Get yours he...
Do Not Look to the Surrogate If the Patient Still Has Capacity
Washington Adventist Hospital in Takoma Park, Maryland was recently sanctioned by CMS for looking to a surrogate rather than to the patient herself when the patient still had capacity."According to her medical record patient #1 was alert and oriented x4 with a period of delirium for several days while in ICU. There was no documentation in the medical record that patient #1 lacked capacity.""Patient #1's granddaughter in Florida expressed concerns...
Chủ Nhật, 21 tháng 6, 2015
Letter Remained Unfinished [EOL in Art 42]
Vasily Vereshchagin has a series of these cards. The prior one has the nurse writing a letter for the patient but that is "interrupted" by an emergent medical need. Apparently, the patient never got to finish the lett...
Ontario Medical Board Cautions Physicians for Writing Unilateral DNR Order (Wawrzyniak v. Chapman & Livingstone)
Various Ontario tribunals have issued quite a few decisions (example) arising out of the civil and administrative complaints filed by Elizabeth Wawrzyniak against several clinicians at Sunnybrook Health Sciences Center involved in the death of her father on September 22, 2008. The latest one (23 single-spaced pages) was delivered just a few days ago by the College of Physicians and Surgeons of Ontario.This is the third time that the College...
Thứ Bảy, 20 tháng 6, 2015
ASBH Annual Meeting (October 2015)
Register here for the 17th annual meeting of the American Society for Bioethics & Humanities (ASBH) in Houston, October 22-25, 2015. I will be presenting in two panels:Legal Update 2015: Top 10 Legal Developments in BioethicsThe Unbefriended Must Not Be Unprotected: Organizational and Clinical Management of Patients Without SurrogatesThe rest of the program looks great too, from art, to anthropology, to philosophy, to medicine, and mo...
Hospital Sanctioned for Patients Lacking POLST
Northwest Hospital Center in Randallstown, Maryland received this statement of deficiencies compiled by health inspectors for the Centers for Medicare and Medicaid Services."Based on observation, medical record review, and interview of the licensed nursing and risk management staff, it was determined that not all patients consistently had . . . MOLST . . . ."3.) Patient #8 . . . Review of the medical record on 11/12/14 revealed that there was...
Fin - by Kotarbinski [EOL in Art 41]
Wilhelm Kotarbinski (1849-1921) produced a lot of fantasy painting. But "Fin" seems more realistic. &nb...
Thứ Sáu, 19 tháng 6, 2015
Savulescu on Rationing in the NICU
The Australian Centre for Health Law Research has just posted Julian Savulescu's lecture, last month: "Rationing: The Case of NICU." It is far more defensible to justify treatment refusals on the basis of utilitarian allocation than on the basis of futility or benefit/harm trade-offs.Does your hospital have a policy on resource allocation, so that you have principled grounds for denying treatment on the basis of scarci...
Thứ Năm, 18 tháng 6, 2015
Critically Impaired Infants and End of Life Decision Making: Resource Allocation and Difficult Decisions
Neera Bhatia is a Lecturer at Deakin University School of Law, Australia. She has just published Critically Impaired Infants and End of Life Decision Making: Resource Allocation and Difficult Decisions (Routledge June 2015).Bhatia explores the legal and ethical issues surrounding decisions to withdraw or withhold life-sustaining treatment for babies born on the edge of viability (23 weeks) and addresses the controversial question, are...
Thứ Tư, 17 tháng 6, 2015
VSED - Is It Neglect?
The British Columbia Supreme Court determined that respecting a patient's non-contemporaneous decision to VSED would constitute elder neglect. The Mary Hildreth Winston case going to trial, this month, in Florida also raises the question whether honoring a patient's choice to hasten her death constitutes criminal neglect. &nb...
Alan Watts - Acceptance of Death [EOL in Art 38]
Here is a very well done four minute clip on the importanceof accepting death. It correlates film clips with portions of a lecture by British philosopher Alan Wat...
Thứ Ba, 16 tháng 6, 2015
In the Presence of a Spoon - VSED & Margot Bentley
This past Sunday, CBC aired a 30-minute documentary on the Margot Bentley case.The description reads: "Margot Bentley was a nurse in BC who made her end of life wishes crystal clear and on paper. Now, 17 years into dementia and many court cases later, she is being kept alive - all because she opens her mouth in the presence of a spoon."I disagree that her wishes were "crystal clear." But I agree with the family that opening her mouth is not...
Thứ Hai, 15 tháng 6, 2015
Youth in Oregon (film)
Look out for the 2016 release of "Youth in Oregon." This is a comedic drama about a man who must drive his 80-year-old father-in-law cross country for aid in dying. The cast includes Frank Langella and Christina Applega...
Death the Friend [EOL in Art 36]
Alfred Rethel (1816–1859) was best known for painting images based upon German history of stories from the Old Testament, but from about 1848 he did a series of drawings with Death as a central character. Here, death is tolling the bell for this old m...
Chủ Nhật, 14 tháng 6, 2015
Thứ Bảy, 13 tháng 6, 2015
"I Am Dying" - National Geographic
Tonight, the National Geographic Channel has a one-hour special "I'm Dying." The show follows 32-year-old Renee Heidtman during the last months of her life capturing intimate moments through photos, camera work and Heidtman's personal video diary of her experience that she started when she was diagnosed in 2009.The filmmakers had a goal of documenting death in an intimate way. Film crews hung out with the Heidtmans for nearly two...
Limits of Medicine [EOL in Art 34]
Daumier's satirical work is legendary. Here, he has two doctors arguing and pointing to their books. Meanwhile death is dancing by the patie...
Calculate Your Risk of Dying in the Next 5 Years
Determine your chance of surviving the next five years - with 80% accuracy. The Ubble website launched here a few days ago. &nb...
Baby Boomers for Balanced Health Care - Goldilocks Healthcare
Baby Boomers for Balanced Health Care is a group of concerned citizens looking for "balanced" health care. They want "Goldilocks health care" - not too much, not too little.&nb...
Thứ Sáu, 12 tháng 6, 2015
Samadhi 4D Death Simulator
Last summer in Shenzhen, China, an amusement park opened the Samadhi 4D death simulator. Participants can experience what it’s like to get cremated and reborn in a uterus. (CNN; Motherboard)Players compete in a series of challenges in which everyone is trying to avoid the ultimate penalty—death. Players who "die" in the game (and in the end, all the players die) are placed in a coffin, then carried to a large furnace via conveyor...
More Doctors Going to Jail for Gross Negligence
In a recent issue of the Medico-Legal Journal Alec Samuels observes: "A finding of civil negligence is bad enough; a verdict of criminal negligence is truly tragic.""There are not many prosecutions . . . however, prosecutions are now more common than before." He reviews several recent cases. I will be collecting the U.S. cases later this year. &nb...
POLST or Advance Directive [EOL in Art 33]
I started this series with a photo that I took while at the Harvard Art Museums. Like that painting, the main character in this painting ("Last Will" by Nikolay Bogdanov-Belsky ) would be dictating a POLST, not an advance directi...
Thứ Năm, 11 tháng 6, 2015
New Jersey Again Worst in ICU Use at End of Life
A few days ago, the United Health Foundation released the 2015 edition of America's Health Rankings: Senior Report. ICU use is one core measure. "Overusing the critical care system is costly and often goes against the wishes of dying patients. While not correlated with better outcomes or longer life, intensive care unit (ICU) use is correlated withavailability of ICU beds; this could indicate a supply-induceddemand. Areas with...
Palliative Care Is the Path Alongside the River of Curative Treatment
Dominic Wilkinson is a Consultant Neonatologist and Director of Medical Ethics at the University of Oxford. A recent short article on prognostication includes a great metaphor for palliative care."Conventional medical treatment is more akin to a river, while palliative care is the path running alongside. Sometimes it is appropriate to climb out of the water, and to walk more slowly along the towpath. Often, once people have left...
Sky Light - A Cemetery that Glows [EOL in Art 32]
Sky Light transforms the idea of dark and gloomy cemetery in a natural experience, simple and happy through a series of natural elements like water, flora and light. Each of the remains are introduced into an urn, sealed, and placed in an urn light containing an LED system. Each urn can be placed in a family tree, or hung on a constellati...
Thứ Tư, 10 tháng 6, 2015
Wild Variations in Hospice Use across USA
These data has long been published in the Dartmouth Atlas. But seeing it in the 2015 America's Health Rankings Senior Report is a reminder. Hospice use varies from 65% in Arizona and Utah to just around 30% in New York, Alaska, and North Dako...
Modern Tomb [EOL in Art 31]
Pedro Dias designed "Family Tomb in the Açor Mountains" to have the interior as an open space, accessible to all, equipped with a bench, which serves both as such as well as a surface for placing the coffin during the mentioned funeral ritual. The contemplative “spatial void” fulfills the “emotional void” caused by a feeling of lo...
New Award Recognizing Health Law-Related Service to the Community
Nominate a Colleague for New Award Recognizing Health Law-Related Service to the CommunityThe AALS Section on Law, Medicine and Health Care created a new award in 2014 to recognize outstanding contributions of law teachers in the service of health law. The award is designed to recognize a wide variety of community service activities, including: pro bono litigation, legislative advocacy, leading or consulting on public initiatives, and other public or private projects. The service may be local, regional, national or international...
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