https://www.thehastingscenter.org/ethical-perspectives-advance-directives-dementia/
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When people ask me what kind of medicine I practice, I most often say family medicine. Now, however, I am also apt to say I practice “democratic medicine.” What is democratic medicine? Less a style than a way of being, it embodies five principles born of democratic values related to history, duty, community, citizenship, and… Read more
BIOETHICS FORUM ESSAY
I suspected the two alibi witnesses were lying. The accused in the case, Alexei Melnikov, coached long distance walkers and runners for ARAF, the All-Russia Athletic Federation. Lilya Shobukova and her husband testified that they handed over 150,000 Euros in blackmail money to Melnikov in Moscow in January 2012. He alleged this was impossible because… Read more
In 2012, I coauthored a case report about the successful use of dietary supplements in treating a case of male infertility in the American Family Physician. Before it was published, I was surprised to receive a communication asking me to disclose the fact that I had written a textbook on dietary supplements. It had not… Read more
Last March, 4,000 frozen eggs and embryos were lost at University Hospitals Fertility Center in Cleveland when the temperature in cryogenic tanks spiked due to human error. Officials at University Hospitals have apologized repeatedly to the affected patients, and say that they are working to provide refunds, free services, and “emotional support.” A similar incident… Read more
Last month, England announced that it would allow women to take the second pill required for a medical abortion–misoprostol–at home, rather than requiring them to travel to a clinic. The policy brings England in line with Scotland and Wales, as well as many other countries, and it eliminates significant obstacles to legal abortion for many… Read more
Four articles in the Hastings Center Report make an array of claims about whether advance directives should or should not be used to instruct caregivers to withhold oral feeding of a person who reaches a designated stage of dementia. I would like to advance some central ethical observations on the matter. A life can be… Read more
In “Avoiding Deep Dementia,” an essay in the current issue of the Hastings Center Report, legal scholar Norman Cantor explains why he has an advance directive that calls for voluntary stopping of eating and drinking as a means of ending his life if he develops dementia and reaches a particular state of decline. Cantor’s essay… Read more
A long-anticipated policy change proposed by the Trump administration that would count the use of many federally-subsidized programs against immigrants currently eligible to use them threatens public health and would undermine ethical practice in health professions and systems. The policy would expand the definition of a public charge, someone likely to become dependent on government… Read more
I founded a bioethics club at my high school in the beginning of my sophomore year. From a very young age, I always considered it important to do the “right thing.” However, as I grew older and was confronted with more complex situations, I realized that the “right thing” is not always obvious. I found… Read more
Earlier this month, The Seattle Times published an op-ed by Samuel Browd, medical director of Seattle Children’s Sport Concussion Program, on the risks of brain injury in youth sports. Dr. Browd acknowledged troubling research on the dangers of repetitive brain trauma, but also emphasized that millions of children “have played contact sports without overt symptoms” and… Read more
Twice upon a time, there was a girl who died. The death certificate that New Jersey issued to 17-year-old Jahi McMath on June 22 was the second one issued for her. California issued McMath’s first death certificate in December 2013. McMath had been admitted to Children’s Hospital Oakland on December 9 for a routine tonsillectomy… Read more
Dying cannot be understood properly, or responded to well, without recourse to the connections between the dying experience and the larger social structures that make up a social and civic community. To develop this perspective further, it is important to envision a new kind of palliative care system that extends beyond professional expertise and a… Read more
