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Kathryn Mannix: How Our Lives End Must No Longer Be a Taboo Subject

August 16, 2018

Any day spent in a hospital emergency department shows how the illusion that we are in control of our lives can be shattered by the laws of nature, which can catastrophically change everything, unexpectedly rendering us helpless, damaged or dead

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Kathryn Mannix: How Our Lives End Must No Longer Be a Taboo Subject

Thursday, August 16th, 2018

The suddenly-ill are rescued by modern technological interventions whenever possible; it is assumed to be in the patients’ best interests to survive and recover. But the interventions may result in very little, if any, quality of life and instead only prevent “natural dying”. This is a new problem, born of technological progress. Where does it leave us?

This summer, after considering the case of a man known only as “Mr Y”, the UK supreme court clarified that judges need not be consulted if a clinical team and a patient’s family agree – after careful discussion following best practice and legal guidelines – that it’s not in the best interests of a patient with a prolonged disorder of consciousness to continue artificial hydration and nutrition. It is permissible to withdraw this treatment and allow their dying to proceed naturally. …

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The Guardian

There’s a Surprisingly Rich Debate About How to Define Death

August 7, 2018

The story of Jahi McMath, a teenage girl who died this summer, shows how painful a lack of consensus can be for families

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There’s a Surprisingly Rich Debate About How to Define Death

Tuesday, August 7th, 2018

What is death, really?

Turns out there’s no true consensus among doctors, bioethicists, and philosophers. The way death is determined can even change as you cross state lines.

Is it when our brains completely shut down? Is it when parts of our brains stop working? Is it when our hearts or lungs stop working? Is it when we lose the ability to think?

…continue reading ‘There’s a surprisingly rich debate about how to define death’

Image By Genesis12~enwiki at English Wikipedia – I the creator of this work (also my brain in the MRI image) allow anyone to use this image., CC BY-SA 2.5, https://commons.wikimedia.org/w/index.php?curid=60865105

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Vox

Why the Case of Jahi McMath Is Important for Understanding the Role of Race for Black Patients

July 12, 2018

California teenager Jahi McMath, who suffered catastrophic brain injury as a result of a routine tonsil surgery, died on June 22, 2018. Her death came after four years of her family fighting in court to continue her care in California. Eventually, they moved her to a facility in New Jersey, a state that accommodates religious views that don’t recognize brain death

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Why the Case of Jahi McMath Is Important for Understanding the Role of Race for Black Patients

Thursday, July 12th, 2018

California teenager Jahi McMath, who suffered catastrophic brain injury as a result of a routine tonsil surgery, died on June 22, 2018.

Her death came after four years of her family fighting in court to continue her care in California. Eventually, they moved her to a facility in New Jersey, a state that accommodates religious views that don’t recognize brain death.

Much of the popular discussion in the case centered on the family’s refusal to accept the diagnosis of brain death. However, as a philosopher who writes on bioethics and race, I believe an underappreciated aspect of the discussion was the role of race – both in how the medical personnel dealt with the family and how the family interpreted their interactions with the medical establishment.

…continue reading ‘Why the case of Jahi McMath is important for understanding the role of race for black patients’

Image via Flickr License Some rights reserved by zennie62

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The Conversation

The AMA Has Long Opposed Assisted Suicide

June 11, 2018

Is that about to change?

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The AMA Has Long Opposed Assisted Suicide

Monday, June 11th, 2018

During his three decades as an emergency-room doctor, Bob Uslander had never written a prescription for a lethal dose of medication. But then he shifted to geriatric and palliative care, and in 2016, a patient suffering from the neurodegenerative disease amyotrophic lateral sclerosis (ALS) wanted to use California’s new physician-assisted death law.

Uslander was apprehensive. Until then, he had always viewed death as a failure.

“I didn’t really know what it would be like to be with somebody who had made the choice and was taking this medication,” he recalled recently. “I didn’t know if they would just gently fall asleep or if they would be gasping or struggling.”

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Washington Post

Beyond Legalization

May 31, 2018

Dilemma physicians confront regarding aid in dying.

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Beyond Legalization

Thursday, May 31st, 2018

By Bernard Lo, MD

“What do you think about physician aid in dying?”

Because 18.2% of the U.S. population lives in jurisdictions where physician aid in dying (PAD) is now legal, physicians need to anticipate that patients may inquire about or request it. Two decades ago, when PAD was illegal throughout the United States, 18.3% of physicians reported ever having received a request for assisted suicide¹; inquiries are likely to be more frequent now. But physicians may feel unprepared, uncertain, and uncomfortable when confronting these conversations, even if they’ve thought through their own position on PAD legalization.

Physicians can start by clarifying what patients are asking and why. Some ways in which patients might raise the topic of PAD are listed in the box. Not every question about PAD is a request for assisted suicide. Patients might be seeking information, talking through concerns, expressing distress, or trying to ascertain the physician’s views. To clarify the patient’s motivation, physicians might say, “I’ll be glad to answer that question, but first please tell me what led you to ask.”

…continue reading ‘Beyond Legalization — Dilemmas Physicians Confront Regarding Aid in Dying’

Image via Flickr Some rights reserved by CTSIatUCS

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NEJM

After You Die, Some Things In Your Body Keep On Ticking

May 25, 2018

When you’re dead, you’re dead—right? No pulse, no brain activity, no signs of life. But at the cellular level, things can still be ticking right along—cells and processes ignorant of the fate of the whole organism. And some things—such as developmental genes—even kick into gear

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After You Die, Some Things In Your Body Keep On Ticking

Friday, May 25th, 2018

This video explores what scientists are learning about what happens inside our bodies after we die—and how it could lead to everything from better organ transplants to accurately estimating time of death.

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Science

Die Like a Dog

May 15, 2018

Pet dogs often have a peaceful death that forestalls protracted suffering and pain. Why can’t we do the same for humans?

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Die Like a Dog

Tuesday, May 15th, 2018

By Joseph Pierre,

I killed my dog last year. Mika was a shelter mutt, so she was around 10 or 12 years old; I can’t be sure. Twelve dog years would have put her at around 80 human years, which is a pretty good run. But what’s strange about having a dog is how quickly they age relative to us – they start out younger than we are, catch up for a time, and then pass us by, declining into their twilight years, all in the space of a decade or so. As witnesses to that accelerated timeline, having a pet means that we often end up experiencing their eventual demise and learning something about death in the process.

Mika was a great dog. Obviously abused before ending up at the shelter, she had scars on her head when I rescued her and, whenever I took a broom or rake in my hand, she would cower in fear. She was easily overwhelmed when other dogs came up to sniff her, and would often growl defensively. But with time she grew to be less apprehensive and almost pathologically affectionate, if there is such a thing with animals, demanding to be petted by anyone who happened to be near. She was a great companion watching TV on the couch during my single years, and she helped me win the attention of the woman, a veterinarian, who would eventually become my wife. In fact, my wife has often joked – and maybe it isn’t a joke at all – that she would never have gone out with me in the first place if I hadn’t had a dog.

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Image: By DodosD – Own work, CC BY-SA 3.0, https://commons.wikimedia.org/w/index.php?curid=17873917

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aeon

Hawaii’s New End-of-Life Law

May 7, 2018

Do the additional safeguards withstand scrutiny?

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Hawaii’s New End-of-Life Law

Monday, May 7th, 2018

By Katherine Drabiak

Last month, Hawaii became the seventh state, with the District of Columbia, to legalize physician-assisted suicide. Similar to some of the other state laws, Hawaii’s Our Care, Our Choice Act permits competent adults with a terminal illness and a diagnosis of less than six months to live to obtain a lethal prescription to use to take their own lives. Proponents assert the new law, in addition to giving patients a measure of control, autonomy, and dignity, also contains rigorous safeguards. Despite this rhetoric, Hawaii’s law, like legalized PAS in general, raises troubling implications for the standard of care and for transparency. It also highlights the immense power of a lobby, Compassion & Choices, to strategically politicize language and control the public discourse to make legal change appear to result from organic social shifts rather than orchestrated actions.

Terminology matters: framing a lethal prescription as a viable and even desirable alternative to addressing shortcomings in palliative and hospice care obfuscates that “care” and “choice” mean supplying vulnerable patients with a medication to end their life. Under the prevailing medical standard of care, patients who report feeling depressed, a burden to others, trapped, or hopeless, or are struggling with managing their medical condition would ordinarily trigger intervention to address risk factors for suicide. However, lobbyists’ use of euphemistic language may incrementally change how physicians and public health professionals respond to patients who express suicidal thoughts.

… continue reading ‘Hawaii’s New End-Of’Life Law’

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The Hastings Center

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Kathryn Mannix: How Our Lives End Must No Longer Be a Taboo Subject

Kathryn Mannix: How Our Lives End Must No Longer Be a Taboo Subject

There’s a Surprisingly Rich Debate About How to Define Death

There’s a Surprisingly Rich Debate About How to Define Death

Why the Case of Jahi McMath Is Important for Understanding the Role of Race for Black Patients

Why the Case of Jahi McMath Is Important for Understanding the Role of Race for Black Patients

The AMA Has Long Opposed Assisted Suicide

The AMA Has Long Opposed Assisted Suicide

Beyond Legalization

Beyond Legalization

After You Die, Some Things In Your Body Keep On Ticking

After You Die, Some Things In Your Body Keep On Ticking

Die Like a Dog

Die Like a Dog

Hawaii’s New End-of-Life Law

Hawaii’s New End-of-Life Law

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