...
Thứ Hai, 31 tháng 8, 2015
Revisiting CPR Survival Rates Depicted on Popular TV Shows
Jaclyn Portanova and colleagues at the USC Davis School of Gerontology have just published "It Isn’t Like This on TV: Revisiting CPR Survival Rates Depicted on Popular TV Shows" in Resuscitation. Compared to Diem & Lantos' similar 1996 study, accuracy rates of television CPR depictions appear to not be improving. The authors found that Grey's Anatomy and House portrayed CPR as more effective than actual rates. Overall, the shows portrayed an immediate survival rate nearly twice that of actual survival rates....
Chủ Nhật, 30 tháng 8, 2015
Neysi Perez Buried Alive, Wakes Screaming Inside Coffin
Pregnant teenager Neysi Perez was buried alive. She was removed from her tomb and coffin after family members heard her screaming. Her mother said she was still warm. “We were all so happy. After being declared dead for such a long time, everybody was saying that she had come back to life. We were all so happy." (Independent)&nb...
Kevorkian "Coma" [EOL in Art 111]
In "Coma" Jack Kevorkian depicts an unconscious patient being slowly pulled into the mouth of a macabre death mask. Helpless. The death's head resembles the opening of a CAT scan machine, a symbol of modern medical technolo...
New Futility Case: Siner v. Kindred Hospital Indianapolis
The Court of Appeals of Indiana issued a decision that allows a family to proceed with its medical malpractice action alleging that a hospital's unilateral DNR order caused the patient's death. Facts"October 26, 2007, eighty-six-year old Geraldine Siner became a patient at Kindred Hospital. Geraldine suffered from advanced dementia caused by Alzheimer’s disease and as a result could no longer care for herself. Geraldine’s son, John Siner,...
Thứ Bảy, 29 tháng 8, 2015
Kevorkian "Very Still Life" [EOL in Art 110]
In "Very Still Life," Jack Kevorkian's message, "though somewhat capricious, nebulous and indefinable, is clearly underscored by intense feeling. Brilliant colors highlight the melancholoy age-old balance between the warmth of life and the iciness of death, spiced with the sardonic humor of irony.""The disquieting mood portends inescapable doom for the frail symbol of individual life and seemingly callous extinction of its evanescent aura. The age-old...
Supreme Court of Nevada Asked to Determine Brain Death Standards
Earlier this month, the Supreme Court of Nevada ordered a hospital to continue physiological support for a dead woman pending briefing, argument, and adjudication. (I summarize the lower court proceedings here.)Today, the family filed its opening brief. Basically, they make two arguments.First: "The District Court incorrectly interpreted Nevada's Uniform Determination of Death Act (NRS 451.007(1)(b). The plain language of the Act specifically requires that if there is any functions of a person's brain, including his...
Thứ Sáu, 28 tháng 8, 2015
Minnesota Board of Medical Practice at Hamline
Join the Minnesota Board of Medical Practice at Hamline on September 12 for some educational sessions on health l...
The Changing Definition of What Is ‘Brain Dead’
Healthline News has just posted a nice new review of the debate over brain death. It is not 100% accurate. But it is a lucid, comprehensive, lay presentation of the issues. I love this quote from the distinguished critical care specialist and ethicist John Luce: " The brain dead people are not as dead as we once thought they were, in the overall biological sense."The article also notes that Calixto Machado is working on a paper, to be published before the end of the year, which will propose a new category of consciousness...
Medicine Holding Back Death [EOL in Art 109]
The buff man of medicine holding back death itself at Fulton County Health Services in Atlanta. Are we still so confide...
Thứ Năm, 27 tháng 8, 2015
Is ICU Treatment Inappropriate? Clinicians Now Have Guidelines
Medical Ethics Advisor has just posted an article on the new "Official ATS/AACN/ACCP/ESICM/SCCM Policy Statement: Responding to Requests for Potentially Inappropriate Treatments in Intensive Care Units." There are comments from me, Gabe Bosslet, Larry Schneiderman, and Nancy Jeck...
Child's Garden for the ICU [EOL in Art 108]
Lisa Austin, Child's Garden for the ICU, 2001 (casters, steel, pine, plastic laminate, electric light, 6 x 10 x 10 f...
Thứ Tư, 26 tháng 8, 2015
Original Art in the ICU Waiting Room [EOL in Art 107]
Ulla Darno donated this piece for the new ICU Waiting Room at Columbia Memorial Hospital in Hudson, NY with hopes of providing a more peaceful and soothing environment to others during times of stress. &nb...
Thứ Ba, 25 tháng 8, 2015
Original Art in the ICU [EOL in Art 106]
Judith Margolis created these "Panels" for Faraway Places, a project that placed original art made specifically for the Intensive Care Units of Hadassah Ein Kerem Hospital in Jerusalem.&nb...
Canadian Medical Protective Association - End-of-Life Panel
The Canadian Medical Protective Association works to protect the professional integrity of physicians and promote safe medical care in Canada. Its annual meeting starts tomorrow in Halifax. The meeting includes a session on "End-of-Life Care: Medical Legal Issues." Moderator: Mr. André Picard, Health reporter and columnist, The Globe and MailPanelists:Dr. Douglas Grant, Registrar, College of Physicians and Surgeons of Nova ScotiaDr. James Downar, Palliative care physician and intensivist, University Health NetworkMr. Eric...
Thứ Hai, 24 tháng 8, 2015
Do Not Leave Definition of Death Just to Doctors
Andy Ho lucidly explains how the definition of death is value-laden, synthesizing a lot of recent philosophical and medical literature. The issue is more acute in Singapore, because organ donation is presumed and opt-out. "They make a value judgment when they say that the loss of personhood in brain death makes it really death. . . . So what is a moral issue involving life and death has been surreptitiously changed into one about...
Chủ Nhật, 23 tháng 8, 2015
Prescription for Medical Students: A Day at the Art Museum? [EOL in Art 104]
A study just published in NEUROLOGY (abstract here) shows a new way to help medical students learn about dementia - at the art museum. "A day at the museum might be a wise prescription for helping students become compassionate doctors and giving them a better understanding of how patients and caregivers continue their relationships and quality of life despite their diagnosis.""This research adds to a growing consensus about the value...
Futility Dispute - Mary Jane Pierce v. B.C. Women's Hospital
In April, Mary Jane Pierce was born prematurely at 25 weeks with serious health problems. She has cerebral palsy and has suffered multiple hemorrhages that damaged her brain. Next month, a BC court will decide whether B.C. Women's Hospital in Vancouver must maintain life-sustaining treatment.The HospitalAt some point, NICU clinicians determined that interventions to maintain Mary Jane's condition were burdensome...
600 Days of Death - Jahi McMath
DocBastard posts some good thoughts on brain death and the Jahi McMath case by Cory Franklin, a retired ICU physician from Cook County Hospital in Chicago. Franklin had a shorter version of his remarks in the San Francisco Chronicle."Any time you have a diagnosis with an outlier, it’s a good idea to review your original assumptions. In this case our assumptions about what brain death actually i...
Thứ Bảy, 22 tháng 8, 2015
Stop Futile Treatment - Be Surgeons, Not Sissies
At a recent panel discussion on geriatric medicine at Westmead Hospital (in Sydney) several leading specialists agreed doctors should be “surgeons not sissies” and objectively evaluate the prospects of successful treatment.One surgeon, Henry Pleass, remarked: “I work quite closely with physicians in renal transplantation and I’m amazed sometimes these people are still being dialysed. . . . I think: ‘Why on earth are they doing that?’ because they are dialysing a corpse, so to spea...
Thứ Sáu, 21 tháng 8, 2015
Man Experiencing First Real Moment of Peace in Years Resuscitated
The Onion is so funny, because it is so true."Interrupting the only moment of genuine peace the man had known in several decades, a team of paramedics reportedly resuscitated area resident Alan Taborsky this morning following an apparent cardiac arrest.""Reports indicated that just as Taborsky had reached a state of complete relaxation in which he felt unburdened by his life’s troubles for the first time in recent memory, medical technicians wrenched...
Thứ Năm, 20 tháng 8, 2015
LaVecchia Brain Death Dispute Continues in NJ
The New Jersey Record continues coverage of the Michael LaVecchia brain death dispute.The family says that he was wrongly pronounced dead by St. Joseph’s Regional Medical Center. They moved him to Robert Wood Johnson University Hospital.The newspaper story includes a family-produced video showing relatives bending Michael’s bruised index toe on his left foot, which prompted a movement they believed to be a flinch. His mother says: “He’s...
Thứ Tư, 19 tháng 8, 2015
Minnesota Case Illustrates Importance of POLST
Several Minnesota paramedics are under investigation after they stopped resuscitating a nursing home patient at her husband's request. The woman had no POLST, which the paramedics could and should honor. Instead, all they had was the husband's instructions, which they could not honor. I discussed this case briefly on FOX News and in the Pioneer Pre...
More Brain Death Disputes - Michael Lavecchia III
13-year-old Michael Lavecchia III was pronounced brain dead at 11:55 a.m. Sunday at St. Joseph's Regional Medical Center (Paterson, NJ) after his car slammed into the back of a Mack truck. But Michael's mother, Laureen, said that she still wants treatment for her son. Interestingly, Laureen initially consented to organ donation. But then the family had the death certificate "destroyed."As widely predicted, U.S. hospitals...
Aden Hailu - Another Brain Death Lawsuit
Many are following the ongoing (and now nearly two-year-long) series of California lawsuits concerning the life/death status of Jahi McMath. I have collected materials from those cases here.Less well-known is another case, just a few hours away, now being briefed to the Supreme Court of Nevada.Aden Hailu was declared dead at St. Mary's Regional Medical Center more than four months ago, on April 17, 2015. But her family objected to stopping...
Thứ Ba, 18 tháng 8, 2015
Health Care Reform in Minnesota: Mission Advanced But Not Accomplished
The Hamline Law Review has just published its Symposium Issue: Health Care Reform in Minnesota: Mission Advanced But Not Accomplished, Volume 38, Issue 2 (2015). This is the printed product from the Hamline Health Law Institute's October 2014 conference.HEALTH CARE REFORM IMPLEMENTATION IN MINNESOTA: MISSION ADVANCED BUT NOT ACCOMPLISHED: AN INTRODUCTION TO THE SYMPOSIUMThaddeus M. PopeKEEPING OUR EYES ON THE PRIZE: EXAMINING MINNESOTA...
The Knife and Gun Club: Scenes from an Emergency Room [EOL in Art 99]
In The Knife and Gun Club: Scenes from an Emergency Room, award-winning photojournalist Eugene Richards explores the emergency room of Denver General Hospital.A witness to terrible pain, to life-and-death decisions, and to occasional joy, Richards came to view the emergency room as a microcosm of life, where the restarting of a stopped heart hold the promise of the future, where a six-hour gunshot-wound emergency carries the hurt of assassination...
Thứ Hai, 17 tháng 8, 2015
Lessons from the Death of Charles II [EOL in Art 98]
In 1685, King Charles II had fourteen royal physicians, all under great pressure to save his life. He endured excruciating agonies in the name of medicine before he finally expired. 330 years later, many Americans regularly get similarly torturous medicine in a futile attempt to save their lives. Let sixteen ounces of blood from a vein in the king's left armAdditional eight ounces by a method called cupping, in which the king's...
Chủ Nhật, 16 tháng 8, 2015
Comforting the Dying [EOL in Art 97]
In "La Miseria" Cristóbal Rojas depicts a man sitting vigil next to a female companion suffering from tuberculos...
POLST Designers Must Consult Medical Ethicists
At least four states enacted new POLST statutes this year: Delaware, Georgia, Kentucky, and Wyoming. In these laws, the legislature typically delegates to the Department of Health or to a licensing board the job of developing rules and the form itself. The legislature also often directs the agency to consult with "appropriate professional organizations." These typically include, emergency medicine, hospice and palliative care, patient advocacy, and right to life. Notably, Wyoming included "medical ethicist...
Thứ Bảy, 15 tháng 8, 2015
Ethics Consultation Responding to Ethics Questions in Health Care
The Veterans Health Administration has just released the second edition of Ethics Consultation Responding to Ethics Questions in Health Care. It is available for free here."Ethics Consultation: Responding to Ethics Questions in Health Care establishes IntegratedEthics® (IE) standards for health care ethics consultation, one of the three core functions of IE, a comprehensive and systematic approach to ethics in health care developed by the National...
Humanities in Medicine Symposium [EOL in Art 96]
On November 15 and 16, the Mayo School of Continuous Professional Development is producing the Humanities in Medicine Symposium.The symposium is designed to engage artists and healthcare providers who have an interest in building or expanding arts in health care.You are invited to submit an abstract to showcase innovative and unique arts in healthcare programs, and to explore vital themes, emerging research and innovation in the field. The...
Thứ Sáu, 14 tháng 8, 2015
Saying No: Exploring the Ethical Dimensions of Refusals in Healthcare
On Friday, September 18, 2015 in Asheville, North Carolina, MAHEC presents "Saying No: Exploring the Ethical Dimensions of Refusals in Healthcare."Refusals take place across the spectrum of healthcare The clinician who refuses to offer treatment believed to be futile, non-beneficial or inappropriateThe patient who spurns a proposed discharge planThe family who declines to discuss changes in goals of careThe hospital system that decides not to...
Thứ Năm, 13 tháng 8, 2015
Death with Dignity in Washington State - 6th Annual Report
The Washington State Department of Health has just issued its sixth report on Death with Dignity.In the six years since Washington’s Death with Dignity Act went into effect and since that time, 725 adults with a terminal illness have chosen to end their lives with a physician-prescribed lethal dose of medication.There were 176 terminally ill patients in 2014 who received a prescription to help them end their lives. The prescriptions were written...
Thứ Tư, 12 tháng 8, 2015
Nevada Supreme Court Orders Physiological Support for Dead Girl
I will summarize the case shortly. Here is the front page of the order. Initial court filings are he...
New Mexico Appeals Court Reverses Ruling that Legalized Aid in Dying
The New Mexico Court of Appeals has just reversed a January 2013 lower-court ruling establishing the legality of physician aid in dying.In a 144-page opinion, the three-judge panel ruled 2-1 that the district court had erred when it determined that “aid in dying is a fundamental liberty interest. “We conclude that aid in dying is not a fundamental liberty interest under the New Mexico Constitution.” &nb...
Nominate this Blog for the ABA Blawg 100
If you find this blog of value, please consider nominating it for the American Bar Association's 100 best legal blogs.Nominations are due here by August 16, 20...
Court Declares VSED Illegal
Santhara means a fast unto death. In this practice in the Jain community a person stops eating and even drinking water and awaits death. I first discussed Santhara in a comprehensive look at VSED 2011.On Monday, the Rajasthan High Court declared the practice illegal. (Times of India)The court called the practice punishable under section 309 of the IPC as an attempt to commit suicide. The court also ordered support to Santhara...
Cheating Death - Chess Match in Seventh Seal [EOL in Art 93]
Ingmar Bergman's 1957 film "Seventh Seal" is a classic of world cinema. Knight Antonius Block return after fighting in the Crusades. On the beach immediately after his arrival, Block encounters Death. Block challenges Death to a chess match, believing that he can forestall his demise as long as the game continues. Like many in US hospitals today, Block tries to cheat death even though that is obviously futi...
Thứ Ba, 11 tháng 8, 2015
Aid in Dying Political Cartoon [EOL in Art 92]
This political cartoon from a New Jersey newspaper captures a serious flaw in the opposition to legalizing aid in dyi...
Downside of Life-Prolonging Technology
A great story in Health Affairs titled "A Failing Heart And The Downside Of Life-Prolonging Technology" was reprinted in the Washington Post as "The Device Kept Him Alive, But Was the Pain and Suffering Worth It?"I especially like this excerpt" "With very few exceptions, virtually everyone in need of an LVAD is saying yes to the therapy. When such technologies were first introduced in the late 1980s, they were reserved for patients with...
Thứ Hai, 10 tháng 8, 2015
Advance Directive on Etch a Sketch [EOL in Art 91]
Nobody literally records their advance directive on an etch a sketch. But it too often seems a reasonable representation of most advance care planning - insufficient guidance for clinicians, insufficient guidance for famili...
Denying Ourselves the Right to Make Rational Choices about Death
Former Congressman Barney Frank offers his support for Medicare coverage of advance care planning. He urges changing a set of policies that not only do not advance our welfare, but also diminish it: denying ourselves the right to make rational choices about death.Frank observes that "while there is no clear legal bar to a spouse, child or parent complying with the expressed desire of a brain-dead patient not to be kept breathing artificially,...
Chủ Nhật, 9 tháng 8, 2015
ASBH Annual Meeting - Lots of EOL Sessions
The ASBH Annual Meeting is October 21-25,2015 in Houston. If you are not alreadyplanning to go, check out this huge list of sessions on EOL. And this is just a subset of those on the program.BrainDeathCan the BrainDead be Harmed or Wronged? On the Moral Status of Brain De…Religious Exemptionsand the Duality of DeathAre Brain DeadHuman Beings Really Dead?Done to Death:Yet Another Argument About Defining Death—Where Miller &...
Thứ Bảy, 8 tháng 8, 2015
"Dicing with Dr Death" - Philip Nitschke at the Edinburgh Fringe
See Nitschke “teaching the funny side of the right-to-die debate” to Edinburgh audiences, as well as offering demonstrations of his Destiny euthanasia machine.The synopsis of the show reads: “From his involvement in the deaths of four real-life patients under Australia’s Rights of the Terminally Ill Act, to his fondness for the do-it-yourself approach, Philip takes his audience on a rip-roaring ride through his 20 years working with life’s one certainty: death.”The hour-long show will discuss the history of euthanasia as well as talking about how...
Museum of Death [EOL in Art 89]
This is the front gate to The Museum of Death in Los Angeles. The museum includes lots of explicit footage of autopsies and executions, gory photographs of car accidents and dismemberment. There is a whole room dedicated to serial killer art and memorabil...
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