Archive for category End-of-life Decisions

Dying in Australia

MJA 2010; 193 (5): 249
Author: Martin B Van Der Weyden
“…This inevitability [of death], combined with the fear of an undignified or painful death, has imposed a widespread dread of dying among the community and occasioned calls for active euthanasia. It has also spawned the ascendancy of palliative medicine, with its noble aim of supporting a good death: painless, dignified and peaceful.  A feature of modern health care is its penchant for outcomes, reports and league tables, …view of this obsession, it seems only natural that we are now regaled with a new quality index focusing on dying!  Devised by the Economist Intelligence Unit, the business information arm of news magazine The Economist, the quality-of-death index ranks 40 countries using 24 indicators such as public awareness of end-of-life care and status indicators such as whether a country has a government-led palliative care strategy.”
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How the public responded to the Schiavo controversy: evidence from letters to editors

J Med Ethics 2010;36:571-573 doi:10.1136/jme.2010.037804
Authors: Eric Racine, Marta Karczewska, Matthew Seidler, Rakesh Amaram, Judy Illes
“The history and genesis of major public clinical ethics controversies is intimately related to the publication of opinions and responses in media coverage. To provide a sample of public response in the media, this paper reports the results of a content analysis of letters to editors published in the four most prolific American newspapers for the Schiavo controversy. Opinions expressed in the letters sampled strongly supported the use of living wills and strongly condemned public attention to the case as well as political interventions. Letters tended to be against withdrawal of life support, proxy consent and associated procedures as well as against court decisions and legal procedures. In comparison with reports written by journalists, letters to editors contained fewer controversial claims about Schiavo’s neurological condition and behavioural repertoire but similar loaded language to describe withdrawal of life support.”
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Strange Deathbedfellows

The Hastings Centre Report, Vol. 40, No. 5, September – October 2010
Author: Linda Ganzini
“In 1998 I was hired by a local health care system to evaluate the mental health of enrolled patients who requested lethal prescriptions under Oregon’s newly implemented Death with Dignity Act. …Since then, I have been privileged to interview more than fifty Oregonians who requested legalized, physician-assisted death, as well as their family members, physicians, and hospice providers. These people prize independence, autonomy, self-sufficiency, and control. They want to leave this world in the driver’s seat, and they anticipate a dying process that is incompatible with this goal.”
Find extract here.

Two arrested over assisted suicide

The Guardian, By James Meikle, 2 September 2010

“Pressure group Dignity in Dying said the incident strengthened its argument for a change in the law. It was “a sad reminder of how our current law is failing dying patients and their loved ones”, said chief executive Sarah Wootton. She said: “Much better would be an assisted dying law with upfront safeguards, which would investigate a request to die when the person is still alive and alternative options can be set out.”

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Do religious doctors prolong dying patients’ pain, know their wishes?

USA Today, AP, 27 August 2010

“According to the Associated Press, the study, funded by Britain’s National Council for Palliative Care and released this week online in the Journal of Medical Ethics finds:  Doctors who described themselves as “extremely” or “very nonreligious” were nearly twice as likely to report having made decisions like providing continuous deep sedation, which could accelerate a patient’s death.  But the study also found. Doctors who were religious were much less likely to have talked about end of life treatment decisions with their patients.  To ensure doctors are acting in accordance with their patients’ wishes, the study’s author, Dr. Clive Seale wrote that “nonreligious doctors should confess their predilections to their patients.”

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Atheist doctors ‘more likely to hasten death’

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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End-of-Life Wishes

JAMA. 2010;304(8):846. doi:10.1001/jama.2010.1199
Author: Bridget M. Kuehn
“Patients who used a standardized form signed by a physician to express their wishes for care at the end of life were more likely to receive their preferred level of care than patients who used more traditional methods such as advance directives and do-not-resuscitate orders, according a study funded by the National Institute of Nursing Research.”
Find extract here.

Who should decide when care is futile?

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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Wait for transplants may be cut as study finds kidneys from dead donors are viable

The Times, David Rose, August 19, 2010

“More patients could receive kidneys from recently deceased donors after a study found that they perform just as well as those from brain-dead donors, who are not expected to recover.  The findings pave the way for reforms in transplant policy that could make an estimated 600 extra donor kidneys available to the NHS every year.”

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Doctor won’t face charges after helping woman to die

Scotsman- 17 August, 2010

Author: Shan Ross

“A retired Scottish doctor who was facing prosecution in an assisted suicide case has had the charges against her dropped. Dr Wilson was the first person to be arrested since new guidelines were issued for England and Wales clarifying when people are likely to be prosecuted.”

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