In a recent commentary, physician Alan Astrow  expressed skepticism about the legalization of medical aid in dying.  He cited the subjectivity of determining whose suffering qualifies for medical assistance and...

Most patients who die with medical aid in states where the practice is legal are enrolled in hospice, but coordination between those providing hospice care and those providing medical aid-in-dying (MAiD) is woefully inadequate. Many hospice facilities have policies against supporting patients who request MAiD and do not disclose these policies to prospective patients, even in states where disclosure is required.

The reversal of Roe may be the beginning of an onslaught on our freedoms. I want to add one more worry to the list and point to self-determination at life's end. Here we have Justice Neil Gorsuch to worry about.

Oregon, which legalized medical aid in dying (MAID) in 1997, has dropped the requirement that had limited MAID access to residents of the state. What are the ethical and social implications of this policy change?

Advance care planning has recently come under fire from physicians who say that it does not work and that there is too little evidence in favor of it. Giving up on advance care planning is not called for by the evidence and doing so would mean giving up significant benefits.

The pandemic magnified the inherent difficulty and stress of conversations involving life-sustaining treatment by forcing clinicians and patients to engage in life-altering discussions via telephone and video conference, restricting nonverbal communication and eye contact, and eliminating the benefit of simply having another person nearby in time of crisis.

One of the factors considered most important by dying patients and their families is the opportunity to be together. For many of our hospitalized patients in palliative care, the presence of loved ones at the bedside is such a given that we don’t even address it explicitly in advance care planning discussions. So, it comes as no surprise that Covid- 19-related visitor restrictions affecting hospitalized patients might impact end-of-life decision-making, potentially in ways that are ethically problematic.

Older black Americans are half as likely as older whites to have advanced directives. My patient, a black man in his 70s,, first made his wishes known when he was in the hospital with Covid-19.

I helped develop guidelines for the ethical allocation of scarce resources during a public health emergency, such as a pandemic..I hope my contributions have an impact. I especially hope to see my work used since it emphasizes the perspectives of minority and underserved communities, who tend to have less voice in health policy. But now I find myself dreading the use of my work.

Tinslee Lewis, a critically ill 1-year-old girl born with a rare heart defect and severe lung disease, has spent her entire life in the intensive care unit at Cook Children’s Hospital in Texas and undergone multiple surgeries in attempts to save her life. Tinslee’s care team has determined that she has no chance for any meaningful survival and that ongoing intensive care is harmful and causing her undue suffering. They recommend withdrawal of life-sustaining treatment, against the parent’s wishes. Tinslee’s fate is being debated in court.

To address recent lawsuits that question whether the persistent of hormonal functions is consistent with death by neurologic criteria (such as the case of Jahi McMath), we proposed specific mention in a UDDA that loss of hormonal functions is not required for declaration of death by neurologic criteria.

As debates continue about the decisions people make about how to die, I wish to draw wider attention to the death of Paul Drier. There was little extraordinary about his death. He was a widower, had suffered from multiple health problems, and had been on kidney dialysis for 18 months. Considered to be too ill to qualify for a transplant, he decided to end dialysis. Two aspects of Mr. Drier’s death seem worth putting on record for bioethicists to remember.

An essay for Bioethics Forum earlier this month concludes that medical aid in dying is not a human right. But we should have a right to decide what suffering we are willing to endure and receive medical assistance necessary to avoid the suffering we want to avoid.

A New York Times special report on euthanasia of a Paralympics champion in Belgium was ethically problematic for several reasons.

The Kings County Medical Society in New York recently hosted a brunch with New York State legislators. One of the guests was Richard Gottfried, chair of the New York State Assembly Health Committee, who is cosponsoring A2694, a bill legalizing medical aid in dying (MAID). As a medical oncologist with 30 years’ experience treating seriously ill patients, I have concerns about it, and I expressed them to Gottfried.

Kathy Brandt, a leader in the hospice and palliative care movement in the United States, died on August 4. She was 53 and had been diagnosed with a rare, highly aggressive form of ovarian cancer in January. Brandt and her wife regularly posted on social media about their family's end-of-life experiences.

Should religion play a role in a doctor's care of seriously ill patients? The author, a hematologist/oncologist who teaches Jewish medical ethics, writes: "A physician's outlook may be shaped by religious standards without having to impose it on the patient."

Should an elderly person in decent health but "tired of life" be able to die with a physician's assistance? The Netherlands is grappling with this question.

Old Jews are why I am who I am. Not only the old Jews you’d expect–my grandparents and great-grandparents, who came here because, as I learned for a family history...

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...

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...

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...

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...

It’s a little-known and rarely discussed fact of medical practice that doctors value the ability to love our patients. If the thought of doctors loving patients makes you queasy, be...

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...

The death of former first lady Barbara Bush at age 92 was noteworthy in many ways. She was by all accounts smart, sharp and funny, and a fine, helpful wife...

“It was like he thought we were dirt.” This is how Jahi McMath’s grandmother, Sandra, describes having been treated by one of the doctors at the Oakland’s Children Hospital ICU....

I have been opposed to physician-assisted death for well over 30 years. I need to go back to my early days with this issue to lay out some of my...

Little noticed in the United States but a big deal in France, President Emmanuel Macron announced in January that he is creating a bioethics commission to review the country’s policies...

For the first few years after my husband Howard died, I talked to him often. These were not ghostly, paranormal encounters; I was just thinking out loud about my life...

“Death with dignity” for the past 40 years has meant, for many people, avoiding unwanted medical technology and dying in a hospital.  A “natural” death at home or in a...

Reading “After DNR: Surrogates who persist in requesting cardiopulmonary resuscitation” in the Hastings Center Report, I was reminded of Senate Majority Leader Mitch McConnell’s chastisement of Senator Elizabeth Warren’s opposition...

Given the chance, would Supreme Court nominee Neil Gorsuch vote to overturn Roe v Wade? Challenge state "death with dignity" laws?

An old woman desperately needs medical attention. Yet she fiercely refuses every offer of help from friends, neighbors, and the local doctor. No one will get past her door, she...

Ms. Rita, whom I met as a volunteer at a local nursing home, was the most ardent lover of grapes I have ever known. She was confined to a wheelchair...

Sometime around my mid-50’s I began to ask myself a question: how long should I want to live? My father had died at 64, my mother at 85, my various...

A new chapter in efforts to secure legal provisions for physician-assisted dying began last week when the California State Legislature voted to approve the End of Life Option Act. If Governor Jerry...

We science-medicine-poetry junkies, along with a sizeable portion of the world’s population, are mourning the death of Oliver Sacks, the neurologist and author who died last Sunday from metastasized melanoma. And as...

I spent last week in Singapore, where an excellent breakfast of noodles and teah o ais limau (Malaysian-style iced tea with lemon) costs about $2 and is served at an open-air hawker...

Having read with interest Josephine Johnston’s essay on the aid-in-dying case before a court in New Zealand, I’d like to elaborate on some salient points. I have been actively involved with...

A 78-­year­‐old Iowa man, Henry Rayhons, has been charged with third­‐degree felony sexual abuse for having sex with his wife, who had severe Alzheimer’s, in her nursing home on May 23,...

In her New York Times article of January 20, “Complexities of Choosing an End Game for Dementia”, Paula Span reviewed the use of advance directives to withhold food and water as a way...

Brittany Maynard, the courageous 29-year-old woman with terminal brain cancer, ended her life a month ago today. She and her husband had moved to Oregon so that Maynard could take advantage...

Death is hard to deal with anywhere, but France has some contradictory ways of providing end-of-life care, as two recent articles discuss. On the lighter side, Agence France-Presse reports on...

Recently, I spoke with a seasoned health care reporter who was interested in Alzheimer’s and biomarkers because of his own family’s history of this disease. He started by asking, “Why...

I recently gave a talk about Alzheimer’s disease and asked people to imagine two individuals, Manny and Sue. Manny died at 85; he was showing signs of age but living...

 There is a saying in ethics: you can’t get an “ought” from an “is.” Descriptions of the world as it is do not reveal truths about the world as it...

My sister called: “Get the orange card out of my wallet on the table. We need to call the study people.” In July, we got the news – Dad’s colon...

The problems with end-of-life care are clear enough. Patients and their families/significant others still have trouble talking with one another and their doctors about how they would and would not...

Armond and Dorothy Rudolph of New Mexico were evicted from their assisted living facility in January 2011, after administrators called the police and rescue workers and informed them the couple,...

Goldilocks, all grown up and working as a Medicare hospice auditor, checks the records of three patients.  She frowns at Mr. Brown Bear’s record.  He was referred to hospice three...

Belgian twins, Eddie and Marc Verbessem, were euthanized by lethal injection at Brussels University Hospital in Jette in December. The Verbessem brothers, deaf since birth, were cobblers by trade who lived and...

For some years I have been writing about end-of-life care and, of late, focusing on the high costs of that care. I recently had a painful but revealing insight into...