Bioethics Forum Essay
The Medical Humanity of Oliver Sacks: In His Own Words
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...Read “The Medical Humanity of Oliver Sacks: In His Own Words”
Bioethics Forum Essay
Beyond the “Silver Tsunami”: Toward an Ethic for Aging Societies
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...Read “Beyond the “Silver Tsunami”: Toward an Ethic for Aging Societies”
Bioethics Forum Essay
Sex, Consent, and Dementia
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,...Bioethics Forum Essay
Controlling the End Game of Dementia
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...Bioethics Forum Essay
More French Paradoxes
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...Bioethics Forum Essay
A Blood Test to Predict Alzheimer’s Disease: What’s the Elephant in the Room?
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...Read “A Blood Test to Predict Alzheimer’s Disease: What’s the Elephant in the Room?”
Bioethics Forum Essay
Getting from “is” to “ought” Near the End of Life
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...Bioethics Forum Essay
Is Five Hours Too Short to Say Goodbye? My Dad’s Rapid Autopsy
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...Read “Is Five Hours Too Short to Say Goodbye? My Dad’s Rapid Autopsy”
Bioethics Forum Essay
What if the Patient is Your Mother?
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...Bioethics Forum Essay
Goldilocks and the Three Hospice Patients
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...Bioethics Forum Essay
The Death of a Pet: A Glimpse into the Human Future
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...Bioethics Forum Essay
On Living to 100 or More
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...Bioethics Forum Essay
Sweet Grapes at the End of Life
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...Bioethics Forum Essay
The Lady Writer and the Valkyrie: Magda Szabo’s Novel The Door
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...Read “The Lady Writer and the Valkyrie: Magda Szabo’s Novel The Door”
Hastings Center News
Making Treatment Decisions for Patients in Prolonged States of Unconsciousness
They may have suffered devastating brain damage due to traumatic injury, or oxygen deprivation to the brain following a heart attack or stroke. They may be awake but not aware...Read “Making Treatment Decisions for Patients in Prolonged States of Unconsciousness”
Hastings Center News
Robert Wilson Charitable Trust Enables The Hastings Center to Set Priorities for Future Work on Aging
It’s unusual for a funder to recognize that large societal problems are best addressed after deep reflection and a deliberate and inclusive process of consultation and priority-setting. “But then,” says...Bioethics Forum Essay
Who “Persists” in Opposing DNR Orders? Demographics Matter
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...Read “Who “Persists” in Opposing DNR Orders? Demographics Matter”
Bioethics Forum Essay
Should We Get Ready for Prime Time?
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...Hastings Center News
The “‘Ripple Effect” of Suicide: Hastings Center Cofounder Argues Against Physician Aid in Dying
Is it appropriate for physicians to help patients end their lives? In the current issue of Southern Medical Journal, Hastings Center cofounder Daniel Callahan and Lydia S. Dugdale, an associate...Hastings Center News
National Academies Workshop on Aid-in-Dying Features Hastings Scholars
Hastings Center research scholar Nancy Berlinger and cofounder and President Emeritus Daniel Callahan participated in a major public workshop on February 12 and 13. “Physician-Assisted Death: Scanning the Landscape and...Read “National Academies Workshop on Aid-in-Dying Features Hastings Scholars”
Bioethics Forum Essay
“No one was listening to us.” Lessons from the Jahi McMath Case
“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....Read ““No one was listening to us.” Lessons from the Jahi McMath Case”
Hastings Center News
Defining Death: Public Event Explores the Legacy of Brain Death and the Future of Organ Transplantation
Defining Death: Organ Transplantation and the 50-Year Legacy of the Harvard Report on Brain Death, the 2018 Harvard Medical School’s Annual Bioethics Conference, took place from April 11 to 13...Hastings Center News
Five Physicians Honored for Exemplary Care of Patients Nearing the End of Life
A physician who founded a pediatric palliative care program and another who developed a nationally recognized curriculum to improve communication between doctors and patients with advanced kidney disease are among...Read “Five Physicians Honored for Exemplary Care of Patients Nearing the End of Life”
Bioethics Forum Essay
Palliative Care vs. Cancer Research
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...Hastings Center News
What Does It Mean to be a Good Citizen in an Aging Society?
That question was the focus of “Long Term Care in New York City, circa 2030,” a panel discussion hosted by the New York City Bar Association on May 3 that included...Read “What Does It Mean to be a Good Citizen in an Aging Society?”
Hastings Center News
Hastings Center President Calls for “Moral Leadership” to Improve End-of-Life Care
Are you, as caregivers in a twenty-first century health system, helping your patients and families to make fully informed decisions about the treatments they want and that are likely to...Read “Hastings Center President Calls for “Moral Leadership” to Improve End-of-Life Care”
Hastings Center News
Scanning the Landscape of Physician-Assisted Death
The National Academies of Science, Engineering, and Medicine released Physician- Assisted Death: Scanning the Landscape, proceedings from a two-day workshop convened by the National Academies in February to take a...Bioethics Forum Essay
Envisioning Civic Palliative Care
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...Bioethics Forum Essay
Jahi McMath, Race, and Bioethics
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...Bioethics Forum Essay
Avoiding Dementia, Causing Moral Distress
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...Bioethics Forum Essay
Ethical Perspectives on Advance Directives for Dementia
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...Read “Ethical Perspectives on Advance Directives for Dementia”
Bioethics Forum Essay
Old Jews
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...Bioethics Forum Essay
Religion, Suffering, and the Physician’s Role
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."Hastings Center News
A Preview of Our New Research Agenda: Ethics of Population Aging
In a new essay in the Health Affairs Blog Grantswatch, Hastings Center research scholar Nancy Berlinger and president Mildred Z. Solomon offer a glimpse of the Center’s major new research agenda on the ethics of population aging, with a focus on the precarity of older adults, questions of justice, and issues of personal choice. The work is made possible by a generous grant to The Hastings Center from The Robert W. Wilson Charitable Trust as part of its visionary support for the Center’s research and public engagement on ethical challenges facing aging societies.Read “A Preview of Our New Research Agenda: Ethics of Population Aging”
Bioethics Forum Essay
Live-Tweeting About Dying: Last Lessons from Kathy Brandt
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.Read “Live-Tweeting About Dying: Last Lessons from Kathy Brandt”
Hastings Center News
Five Things Bioethicists See in Our Future
Bioethics Forum Essay
An Incoherent Proposal to Revise the Uniform Determination of Death Act
Read “An Incoherent Proposal to Revise the Uniform Determination of Death Act”
Bioethics Forum Essay
A Responsible Death
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.Bioethics Forum Essay
Revising the Uniform Determination of Death Act: Response to Miller and Nair-Collins
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.Read “Revising the Uniform Determination of Death Act: Response to Miller and Nair-Collins”
Bioethics Forum Essay
Deciding When Enough is Enough in Providing Life-Sustaining Treatment for a Child
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.Read “Deciding When Enough is Enough in Providing Life-Sustaining Treatment for a Child”
Bioethics Forum Essay
Please Don’t (Need to) Use My Work
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.Hastings Center News
Physicians Honored for Outstanding Care of Patients Near the End of Life
Read “Physicians Honored for Outstanding Care of Patients Near the End of Life”
Bioethics Forum Essay
Covid-19 Underscores Racial Disparity in Advance Directives
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.Read “Covid-19 Underscores Racial Disparity in Advance Directives”
Bioethics Forum Essay
“You Can See Your Loved One Now.” Can Visitor Restrictions During Covid Unduly Influence End-of-Life Decisions?
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.Bioethics Forum Essay
Quality of Life? Suffering? Covid-19 Intensifies Challenges in Discussing Life-Sustaining Treatment
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.Hastings Center News
TRANSCRIPT – Breakthrough or Breakdown: Should the FDA Have Approved the New Alzheimer’s Drug?
[Transcript created by voice recognition] Danielle Pacia, The Hastings Center Hello and welcome to Breakthrough or Breakdown. Should the FDA have approved the new Alzheimer’s drug, a Hastings Center conversation?...Page
Hastings Center and Cunniff Dixon Foundation Announce Nursing Awards
The Hastings Center and the Cunniff-Dixon Foundation are pleased to announce two new $25,000 awards to honor outstanding care provided by hospice and palliative care nurses to patients nearing the...Read “Hastings Center and Cunniff Dixon Foundation Announce Nursing Awards”
Page
Hastings Center Announces New Award for Exemplary End-of-Life Care for Vulnerable and Underserved
The award is named in honor of Dr. Richard Payne, an internationally acclaimed leader in palliative care. At the time of his death, Dr. Payne was a Trustee of the...Bioethics Forum Essay
The Death of Advance Care Planning is Greatly Exaggerated
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.Read “The Death of Advance Care Planning is Greatly Exaggerated”
Hastings Center News
Nominate Physicians and Nurses for Outstanding End-of-Life Care
Nominations are open for awards that recognize six physicians and two nurses for providing outstanding care to patients nearing the end of life. The awards are given by The Hastings...Read “Nominate Physicians and Nurses for Outstanding End-of-Life Care”
Hastings Center News
Remembering Andy Baxter, Dedicated Champion of Compassionate Care at the End of Life
The Hastings Center is saddened by the passing of Matthew A. (“Andy”) Baxter, a visionary and dedicated champion for better end of life care, who founded the Cunniff-Dixon Foundation, committed...Read “Remembering Andy Baxter, Dedicated Champion of Compassionate Care at the End of Life”
Hastings Center News
Love and Loss with Amy Bloom
Bestselling author Amy Bloom‘s world was altered forever when an MRI indicated that her husband Brian had Alzheimer’s disease. Together, led by Brian, Brian and Amy made the decision to travel to Switzerland to access an assisted dying process...Hastings Center News
Physicians and Nurses Recognized for Providing Exceptional End of Life Care
The Hastings Center and The Cunniff-Dixon Foundation are pleased to announce nine recipients of awards that honor clinicians for outstanding care provided to patients nearing the end of life. The...Read “Physicians and Nurses Recognized for Providing Exceptional End of Life Care ”
Bioethics Forum Essay
After Roe, What’s Next for End-of-Life Care?
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.Hastings Center News
Three Nurses Recognized for Outstanding End-of-Life Care
The Hastings Center and The Cunniff-Dixon Foundation are pleased to announce the 2023 recipients of The Hastings Center Cunniff-Dixon Nursing Awards, which honor nurses for outstanding care provided to patients...Read “Three Nurses Recognized for Outstanding End-of-Life Care”
Hastings Center News
What Remains of the Constitutional Right to Refuse Treatment?
The Supreme Court’s 1990 decision in Cruzan v. Director, Missouri Department of Health, recognized an individual constitutional right to decline life-sustaining medical treatment. The Court reinforced that right a few...Read “What Remains of the Constitutional Right to Refuse Treatment?”
Bioethics Forum Essay
Hospice and Medical Aid-in-Dying: Addressing an Unethical Disconnect
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.Read “Hospice and Medical Aid-in-Dying: Addressing an Unethical Disconnect”
Hastings Center News
Nominate Physicians for Outstanding End-of-Life Care
Nominations are open for awards that recognize six physicians for providing outstanding care to patients nearing the end of life. The awards are given by The Hastings Center and the...Hastings Center News
Facing Dementia: Clarifying End-of-Life Choices, Supporting Better Lives
A new Hastings Center special report considers how America’s aging society responds to the needs and concerns of people facing dementia. New therapies that may slow progression of this terminal...Read “Facing Dementia: Clarifying End-of-Life Choices, Supporting Better Lives”
Hastings Center News
2024 Hastings Center Cunniff-Dixon Physician Awards Announced
The Hastings Center and The Cunniff-Dixon Foundation are pleased to announce six recipients of awards that honor physicians for providing exemplary care to patients nearing the end of life. The...Read “2024 Hastings Center Cunniff-Dixon Physician Awards Announced”
Page
The Hastings Center Guidelines for Decisions on Life-Sustaining Treatment and Care Near the End of Life, Third Edition
Principal Investigator: Nancy Berlinger Funder: Robert W. Wilson Charitable Trust Start date: 2024 The Hastings Center is preparing the third edition of The Hastings Center Guidelines for Decisions on Life-Sustaining Treatment...
