

What Does the Public Think Should Happen?September 10, 2019 |
When parents and doctors disagree about life support for a child?
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What Does the Public Think Should Happen?September 10, 2019 |
When parents and doctors disagree about life support for a child?
When parents and doctors disagree about life support for a child?
By Claudia Brick and Dominic Wilkinson.
The case of Tafida Raqeeb, currently being heard in the High Court, is the latest high profile legal battle between physicians and parents about life sustaining treatment for a seriously ill child. Since suffering a severe stroke in February, five-year old Tafida has been in intensive care at the Royal London hospital, dependent on mechanical ventilation and artificial nutrition and hydration. According to a statement made by the Barts Health NHS Trust, physicians believe that “further medical treatment would not improve her condition and would not be in her best interests”. Tafida’s parents disagree with this decision and have located doctors in Italy willing to treat their daughter. They have set up a crowdfunding page to try to raise £400,000 to cover treatment, travel and legal costs.
The vast majority of life and death decisions for seriously ill children are made in private, and through consensus between physicians and families. However, prominent cases of disagreement such as that of Tafida Raqeeb, Charlie Gard in 2017 and Alfie Evans in 2018 have brought challenging ethical questions to public attention. When is life worth living and when should treatment be withdrawn, if ever? How much say should parents have in making these decisions? When should scarce resources be considered, if at all?
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Image: By Brian Hall – Own work, Public Domain, https://commons.wikimedia.org/w/index.php?curid=1786487
The Role of Nurses When Patients Decide to End Their LivesSeptember 6, 2019 |
Some hospitals and hospices have policies that forbid nurses to be part of the process or even to discuss end-of-life options
Some hospitals and hospices have policies that forbid nurses to be part of the process or even to discuss end-of-life options
When Ben Wald, 75, was dying of cancer in 2012, he wanted to use Oregon’s Death with Dignity Act to receive a prescription for a lethal medication that would end his life. His hospice nurse, Linda, was part of the discussion and provided both information and support, said his wife, Pam Wald, of Kings Valley, Ore.
His colon cancer had spread to his lungs, and his weight dropped from 180 to 118 pounds. He struggled to speak or eat.
When he was ready to end his life, the couple wanted Linda with them, but the hospice organization she worked for did not allow it, Mrs. Wald said. The organization allowed other hospice workers, such as social workers and massage therapists, to be present, but not the doctors or nurses it employed.
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Thumb image via NY Times
Is Dying at Home Overrated?September 5, 2019 |
A palliative care physician struggles with the complex realities of dying at home, and the unintended consequences of making it a societal priority
A palliative care physician struggles with the complex realities of dying at home, and the unintended consequences of making it a societal priority
By Richard Leiter, M.D.
“If time were short, where would you want to be?”
As a palliative care physician, I regularly ask my patients, or their family members, where they want to die. The specific language I use depends on what they know, what they want to know and how they process information, but the basic premise is the same. Having asked this of hundreds of patients, I have come to expect most will tell me that they want to be at home.
But recently I have struggled with the complex realities of dying at home, and the unintended consequences of our making it a societal priority.
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Image: By Los Angeles – Own work, CC BY-SA 3.0, https://commons.wikimedia.org/w/index.php?curid=4113202
Two brothers are combining palliative care expertise, linguistics and AI to encourage more effective conversations between doctors and people receiving end-of-life care
Two brothers are combining palliative care expertise, linguistics and AI to encourage more effective conversations between doctors and people receiving end-of-life care
One afternoon in the summer of 2018, Bob Gramling dropped by the small suite that serves as his lab in the basement of the University of Vermont’s medical school. There, in a grey lounge chair, an undergrad research assistant named Brigitte Durieux was doing her summer job, earphones plugged into a laptop. Everything normal, thought Bob.
Then he saw her tears.
Bob doesn’t balk at tears. As a palliative care doctor, he has been at thousands of bedsides and had thousands of conversations, often wrenchingly difficult ones, about dying. But in 2007, when his father was dying of Alzheimer’s, Bob was struck by his own sensitivity to every word choice of the doctors and nurses, even though he was medically trained.
Thumb image: (C) Anthony Gerace for Mosaic
The AI That Could Help Curb Youth SuicideJuly 15, 2019 |
For many reasons, parents and teachers may fail to intervene when they spot LGBTQ teens in trouble. Can Google help?
For many reasons, parents and teachers may fail to intervene when they spot LGBTQ teens in trouble. Can Google help?
In suicide-prevention literature, “gatekeepers” are community members who may be able to offer help when someone expresses suicidal thoughts. It’s a loose designation, but it generally includes teachers, parents, coaches, and older co-workers—people with some form of authority and ability to intervene when they see anything troubling.
Could it also include Google? When users search certain key phrases related to suicide methods, Google’s results prominently feature the number for the National Suicide Prevention Lifeline. But the system isn’t foolproof. Google can’t edit webpages, just search results, meaning internet users looking for information about how to kill themselves could easily find it through linked pages or on forums, never having used a search engine at all. At the same time, on the 2019 internet, “run me over” is more likely to be a macabre expression of fandom than a sincere cry for help—a nuance a machine might not understand. Google’s artificial intelligence is also much less effective at detecting suicidal ideation when people search in languages other than English.
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In Secret, Seniors Discuss ‘Rational Suicide’June 25, 2019 |
Ten residents slipped away from their retirement community one Sunday afternoon for a covert meeting in a grocery store cafe. They aimed to answer a taboo question: When they feel they have lived long enough, how can they carry out their own swift and peaceful death?
Ten residents slipped away from their retirement community one Sunday afternoon for a covert meeting in a grocery store cafe. They aimed to answer a taboo question: When they feel they have lived long enough, how can they carry out their own swift and peaceful death?
The seniors, who live in independent apartments at a high-end senior community near Philadelphia, showed no obvious signs of depression. They’re in their 70s and 80s and say they don’t intend to end their lives soon. But they say they want the option to take “preemptive action” before their health declines in their later years, particularly due to dementia.
More seniors are weighing the possibility of suicide, experts say, as the baby boomer generation — known for valuing autonomy and self-determination — reaches older age at a time when modern medicine can keep human bodies alive far longer than ever before.
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thumb image via (Caitlin Hillyard/KHN)
Die. Freeze Body. Store. Revive.June 21, 2019 |
Until the day he died, in 2011, Robert Ettinger hoped humanity would figure out a way to cheat death. Today, his body is stored in a cryonic vessel filled with liquid nitrogen and frozen to –196 degrees Celsius
Until the day he died, in 2011, Robert Ettinger hoped humanity would figure out a way to cheat death. Today, his body is stored in a cryonic vessel filled with liquid nitrogen and frozen to –196 degrees Celsius
Until the day he died, in 2011, Robert Ettinger hoped humanity would figure out a way to cheat death. Today, his body is stored in a cryonic vessel filled with liquid nitrogen and frozen to –196 degrees Celsius. He lies in cryopreservation at the Cryonics Institute in Michigan—which he founded—alongside his late mother, his first and second wives, and more than 150 other deceased.
“We’re classified as a cemetery, but I would like to think of us as being more like a hospital, caring for patients that are metabolically challenged,” says Ben Best, the president and CEO of the Cryonics Institute, in Myles Kane and Josh Koury’s short documentary about the institute, We Will Live Again.
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Thumb image: U.S. Air Force photo by Staff Sgt. Jessica H. Smith
For each adult saved by this machine — dubbed ECMO, for extracorporeal membrane oxygenation — another adult hooked up to the equipment dies in the hospital. For those patients, the intervention is a very expensive, labor-intensive and unsuccessful effort to cheat death
For each adult saved by this machine — dubbed ECMO, for extracorporeal membrane oxygenation — another adult hooked up to the equipment dies in the hospital. For those patients, the intervention is a very expensive, labor-intensive and unsuccessful effort to cheat death
The latest miracle machine in modern medicine — whose use has skyrocketed in recent years — is saving people from the brink of death: adults whose lungs have been ravaged by the flu; a trucker who was trapped underwater in a crash; a man whose heart had stopped working for an astonishing seven hours.
But for each adult saved by this machine — dubbed ECMO, for extracorporeal membrane oxygenation — another adult hooked up to the equipment dies in the hospital. For those patients, the intervention is a very expensive, labor-intensive and unsuccessful effort to cheat death.
ECMO, the most aggressive form of life support available, pumps blood out of the body, oxygenates it and returns it to the body, keeping a person alive for days, weeks or months, even when their heart or lungs don’t work.
…continue reading ‘Miracle Machine Makes Heroic Rescues — And Leaves Patients In Limbo’
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