Ethics & Health Law News

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Archive for category Futility

Atheist doctors ‘more likely to hasten death’

Aug 26

Posted by Nancy Lentz in Clinical Ethics, Death, End-of-life Decisions, Futility, Principle-Based Ethics | Comments off

The Guardian, By Sarah Boseley, 26 August 2010

“Terminally-ill patients would be well advised to find out the religious beliefs of their doctor, according to research showing the effect of faith on a doctor’s willingness to make decisions that could hasten death.  Doctors who are atheist or agnostic are twice as likely to take decisions that might shorten the life of somebody who is terminally ill as doctors who are deeply religious – and doctors with strong religious convictions are less likely even to discuss such decisions with the patient, according to Professor Clive Seale, from the centre for health sciences at Barts and the London school of medicine and dentistry.”

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Who should decide when care is futile?

Aug 21

Posted by Nancy Lentz in Case Law, End-of-life Decisions, Futility, Health Law, US Health Services | Comments off

The Philadelphia Inquirer, By Arthur Caplan, 19 August 2010

“Ruben Betancourt died on May 29, 2009. Last week, a New Jersey appellate court declined to rule on the heated dispute that had broken out between his family and a North Jersey hospital over stopping his medical care prior to his death. It’s not often that the nonruling of a court holds national significance. But the state Appellate Division’s punt in this case merits our attention.”

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Feeding Tubes In The Elderly Demented?

Aug 14

Posted by Nancy Lentz in End-of-life Decisions, Futility, Health Law | Comments off

Better Health, 13 August 2010

“An article in [last] week’s New York Times entitled Feeding Demented Patients with Dignity suggests that hand feeding dementia patients may be a better option than tube feeding them. My God, are we really putting feeding tubes in the elderly demented? When did this happen? During college, I worked as a nurses aide in a nursing home outside Philadelphia. For 20 hours a week (40 hours in the summer) for two years, I cared for patients in all stages of dementia, from the walking confused through to the end stage, stiffened victims confined to wheelchairs or beds. But in all that time, I never, ever saw anyone with a feeding tube.”

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The parents’ ability to take care of their baby as a factor in decisions to withhold or withdraw life-prolonging treatment in two Dutch NICUs

Jun 8

Posted by Edwina Light in Children, End-of-life Decisions, Futility | Comments off

J Med Ethics 2010;36:336-338 (doi:10.1136/jme.2009.034314)
Author: Sofia Moratti
“In The Netherlands, it is openly acknowledged that the parents’ ability to take care of their child plays a role in the decision-making process over administration of life-prolonging treatment to severely defective newborn babies. Unlike other aspects of such decision-making process up until the present time, the ‘ability to take care’ has not received specific attention in regulation or in empirical research. The present study is based on interviews with neonatologists in two Dutch NICUs concerning their definition of the ability to take care and its relevance in non-treatment decisions.”
Find abstract here.

Ethics of futile care

May 23

Posted by Nancy Lentz in Bioethics, Futility | Comments off

KevinMD, By Jeffrey Hall Dobken, 23 May 2010

“The bioethics community has been working on defining the concept of medically futile care for more than a quarter of a century, yet the debate continues. The way in which the current notion of medical futility becomes folded into the proposed healthcare reform bills is at a critical point.  Sophisticated medical technology that is at once life-saving, life-prolonging as well as death-prolonging has created populations which, in the past, would have died simply because the knowledge, the skills, and the technology to salvage them did not exist. Now that it does exist, selective application of these treatment modalities saves some, yet condemns others.”

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Rethinking Guidelines for the Use of Palliative Sedation

May 17

Posted by Edwina Light in Clinical Ethics, End-of-life Decisions, Futility, Registration and Professionalism, Regulatory Compliance | Comments off

Hastings Center Report 40, no 3 (2010): 32-38.
Author: Jeffrey T. Berger
“The use of  continuous palliative sedation to unconsciousness [PSU] rests on a consensus that leads quickly to controversy. …In short, PSU is both a medical treatment and subject to restrictions that are extraordinary in medicine. Medical authorities have not articulated a cogent medical and ethical rationale for this seeming contradiction. This article delves into this problem, along with some others associated with PSU, and offers revised guidelines for its use.”
Find abstract here.

Critical care for extremely premature babies

May 3

Posted by Edwina Light in Bioethics, Children, Clinical Ethics, Death, Futility | Comments off

The Lancet, Volume 375, Issue 9725, 1 May 2010
Editorial: “Although the continuing ethical and economic debates about provision of neonatal intensive care show no sign of diminishing, a recent study seems to underline the validity of the 2006 Nuffield Council on Bioethics recommendations on resuscitation and care of extremely premature babies. … A study by Ravi Swamy and colleagues, published last week in the Fetal and Neonatal Edition of Archives of Disease in Childhood, confirms that the poor survival rates for extremely premature babies have persisted despite more active resuscitation efforts.”
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Too much of a good thing is wonderful? A conceptual analysis of excessive examinations and diagnostic futility in diagnostic radiology

Apr 6

Posted by Edwina Light in Bioethics, Futility | Comments off

Medicine, Health Care and Philosophy, Volume 13, Number 2 / May, 2010 (doi: 10.1007/s11019-010-9232-9)
Author: Bjørn Hofmann
“It has been argued extensively that diagnostic services are a general good, but that it is offered in excess. So what is the problem? Is not “too much of a good thing wonderful”, to paraphrase Mae West? This article explores such a possibility in the field of radiological services where it is argued that more than 40% of the examinations are excessive. The question of whether radiological examinations are excessive cries for a definition of diagnostic futility. However, no such definition is found in the literature. As a response, this article addresses the issue of diagnostic futility in five steps. … Altogether, too much radiological examination is not a good thing. This is simply because radiological examinations are not unanimously good. Excessive radiological examinations can be defined, but not by one simple general and value-neutral definition.”
Find abstract here.

Cancer and the Media: How Does the News Report on Treatment and Outcomes?

Mar 17

Posted by Edwina Light in Death, End-of-life Decisions, Futility, Health information and education | Comments off

Arch Intern Med. 2010;170(6):(doi:10.1001/archinternmed.2010.11)
Authors: Jessica Fishman, Thomas Ten Have, David Casarett
“Background Cancer receives a great deal of news media attention. Although approximately half of all US patients with cancer die of their illness or of related complications, it is unknown whether reports in the news media reflect this reality. …Conclusions News reports about cancer frequently discuss aggressive treatment and survival but rarely discuss treatment failure, adverse events, end-of-life care, or death. These portrayals of cancer care in the news media may give patients an inappropriately optimistic view of cancer treatment, outcomes, and prognosis.”
Find abstract here.

Prostate test creator labels it a ‘public health disaster’

Mar 16

Posted by Sabina Bhate in Best Interests, Biomedical Research, Futility, Gender, Public Health | Comments off

The Age- 15 March, 2010

Author: Kate Benson

“Richard Ablin, who developed the prostate-specific antigen test 40 years ago, used by about 1 million Australians a year, yesterday agreed it had been proven inaccurate and was ”hardly more effective than a coin toss”.”

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