15:26
HHS is soliciting nominations for a new, non-federal member of the Advisory Council on Alzheimer's Research, Care, and Services. Specifically, the position is for someone with a diagnosis of Alzheimer's disease or a related dementia.
Nominations should include the nominee's contact information (current mailing address, e-mail address, and telephone number) and current curriculum vitae or resume. Nominations submitted within the past 6 months for other positions on the Advisory Council on Alzheimer's Research, Care, and Services will be considered for this position.
Submit nominations by email or FedEx or UPS before COB on June 14, 2013. Nominations should be sent to:Helen Lamont, Ph.D HHS Office of the Assistant Secretary for Planning and Evaluation Room 424E, Humphrey Building 200 Independence Avenue, SW Washington DC, 20201Helen.Lamont@hhs.gov
15:23
In an article forthcoming in the Journal of Law and Medicine, Lindy Willmott, Benjamin White, and Jocelyn Downie examine the law in Australia and New Zealand that governs the withholding and withdrawal of ‘futile’ life-sustaining treatment.
The authors concluded that the general legal position is that doctors are able to determine unilaterally when treatment is futile and so need not be provided. This is either because futile treatment is not in a person’s best interests or because not providing such treatment does not breach the criminal law. They note, though, that the position in New Zealand appears less certain given conflicting judicial statements about the need for family consent.
12:33
My latest blog post for AJOB's bioethics.net, "Defending Disability Discrimination," is available here.
12:42
The World Federation of Right to Die Societies will hold its 20th conference from September 17-21, 2014 in Chicago.
The theme is "Dignity, Choice, Control around the World." The Conference will highlight the universality of the death with dignity movement and the vitality of member organizations around the world.
The tentative schedule includes:
- Solutions for the elderly seeking a peaceful death
- New Zealand’s proposal for an advance directive permitting voluntary euthanasia
- New organization in Hong Kong – will that lead to progress in China?
- Japan: an aged society with no option for refusing treatment
- After the court decision: What’s happening in Columbia?
- Canada: a wide variety of bold approaches
- NuTech: progress and dilemmas
- Why Switzerland has 5 aid in dying organizations, including 3 that work with foreigners
- The Netherlands: the most progressive country
- Doctors and how they want to die
15:27
It appears that the medical futility debate in Brazil looks much like that in the United States. I just read this article by Karla Cristiane Oliveira Silva and colleagues called "Therapeutic Obstinacy in an Intensive Care Unit: Perspectives from Doctors and Nurses" (2012 Escola Anna Nery Revista de Enfermagem 16(4): 697-703) (PDF here).
Here is the abstract:
Therapeutic obstinacy is not a sufficiently studied theme in Brazil, especially on the nursing field. This study aimed to understand the social representations of doctors and nurses, about the excessive investment regarding the terminal patient in an Adult Intensive Care Unit. It is a qualitative, exploratory and descriptive research, founded on Social Representations Theory. Data was collected through focused interviews and participant observation and was interpreted through content analysis. The selection of five nurses and eight doctors to give interviews was carried out for convenience, considering their working shifts. It is possible to conclude that such professionals build their social representations about therapeutic obstinacy, having as a starting point the obstinate requests of the terminal patient's family members to carry out futile measures; difficulties regarding decision making and absence of criteria concerning the limits of investment, as well as the fear of ethical and legal repercussions related to the decisions made.
Here are my favorite excerpts:
If the family is very stubborn, we accept their opinion and do not take a stand. But we know that will end up prolonging the suffering of the patient.
Family members . . . push professionals to invest, unnecessarily in the healing process, the latter in turn, opt for the easy way to please the family instead of working with him on the understanding and acceptance of patient's condition.
Professionals who joined this research consider the lack of transparency in the Brazilian legislation contributes to the health professionals introduce useless therapies.
The ambiguities of Brazilian law regarding the limits of the therapeutic effort contribute significantly to how doctors and nurses are positioned on the use or not of measures of life support.
20:16
Philadelphia prosecutors have charged Herbert and Catherine Schaible with 3rd degree murder after their son Brandon died when the parents turned to faith healing instead of medicine for highly treatable problems. This is typical in these cases, because the parents exceed the scope of their discretion to determine best interests.
Interestingly, it seems that in some states a clinician could act on her conscience based objection. That refusal might similarly lead to the child's death. But unlike the parents, the clinician would be statutorily immune from criminal and other sanctions.
15:03
This summer, World Scientific Publishing will release Iranian physician-bioethicist Alireza Bagheri's new book, Medical Futility: A Cross-National Study (Sept. 2013) (300pp).
Most of the current books (e.g. Schneiderman & Jecker 2011) on medical futility focus on the United States. This book provides extensive international perspectives, allowing healthcare professionals to see how different countries approach the issue of medical futility and their experiences in dealing with this issue. Here is the table of contents:
- So-Called Futile Care: The Experience of the United States
- The Reality of Medical Futility in Brazil
- Medical Futility and End-of-the-Life Issues in Belgium
- The Concept of Medical Futility in Venezuela
- Medical Futility in the Russian Federation
- Medical Futility in Australia
- Medical Futility in Japan
- Ethical Issues and Policy in Medical Futility in China
- Medical Futility in Korea
- Medical Futility from the Swiss Perspective
- Medical Futility in Turkey
- Medical Futility in the United Arab Emirates
- Medical Futility in Iran
