Death & dying

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Unconscious Man with DNR Tattoo Presents Ethical, Legal Challenges

December 4, 2017

An article in the New England Journal of Medicine describes the case of a man  unconscious, in deteriorating health, and without identification or family  who was admitted to a Miami emergency room. Upon examination, doctors found a large tattoo that said DO NOT RESUSCITATE (DNR) on his upper chest. The ER doctors were initially inclined to disregard the DNR, "invoking the principle of not choosing an irreversible path when faced with uncertainty." However, an ethics consultant advocated that the patient's wishes, expressed through his tattoo, be honored. The patient died the next day. Hastings Center Scholar Nancy Berlinger opines, "[It] might have been the most reliable way to make his voice heard. It was right to take it seriously." She is co-author (with Consortium chair Susan M. Wolf and Bruce Jennings of the Center for Humans and Nature) of the definitive Guidelines on the Termination of Life-Sustaining Treatment and the Care of the DyingIn the Washington Post, bioethicist Arthur Caplan discusses the legal implications of the case, noting "there are no legal penalties for ignoring a tattoo that instructs medical personnel not to resuscitate." He goes on to say, “'A tattoo, I think, is best seen as a way to alert medical staff to your wishes or trigger an inquiry to family and friends and partners'. . . adding that patients should keep the actual [advance health-care directive] in a pocket or wallet."

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Public Invited to Weigh in on Toughest Medical Ethics Decisions

August 24, 2016

In the aftermath of Hurricane Katrina, health care providers at Memorial Medical Center in New Orleans faced a grim choice: in the midst of a crisis, who among their patients should be evacuated to better conditions? For many in the general public, news coverage (and later a book) about what happened at Memorial was the first time they truly became aware of medical rationing. The first article in a new collaboration between the New York Times and Radio Lab, "Playing God," describes an unusual public debate on the subject being led by Dr. Lee Daugherty Biddison and her colleagues at Johns Hopkins Hospital. Dr. Daugherty Biddison is leading a task force that will "make recommendations for [Maryland] state officials that could serve as a national model." She and her team are holding a series of public forums to hear opinions from laypeople on topics like: should a doctor be able to remove one person from a ventilator to give it to another with a better chance of surviving? During cancer drug shortages, how should doctors choose which patients receive them? Should such decisions be randomized, through a lottery, or based on a patient's age or likelihood of survival? Renowned bioethicist Ruth Faden of Johns Hopkins Berman Institute of Bioethics praised the effort, noting “It’s a novel and important attempt to turn extremely complicated core ethical considerations into something people can make sense of and struggle with in ordinary language.”

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Disability and End-of-life Medical Options

July 26, 2016

In an editorial in today's MinnPost, Bobbi Jacobsen, who has lived with amyotrophic lateral sclerosis (ALS) for 20 years, commemorates the passage of the Americans with Disabilities Act 26 years ago today by calling upon "the leaders of major disability organizations. . . to recognize that we want to be empowered in our end-of-life medical options, too." The article was written to raise awareness and support for Minnesota's Compassionate Care Act, which is modeled on an Oregon law that permits aid in dying but not assisted suicide. Jacobsen notes that the former only applies to terminally ill people: "Medical aid in dying applies to people who want more than anything to live, but a deadly disease is ending their lives." The bill was introduced in the Minnesota state legislature during the last session and was heard by the Senate Health Committee. It was withdrawn before a vote was taken, but is expected to be introduced again during the next session, which begins in January, 2017. 

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Susan M. Wolf Interviewed on the Future of End-of-Life Care

April 24, 2015

Professor Susan M. Wolf was interviewed today by Kerri Miller on Minnesota Public Radio's Friday Roundtable regarding a New England Journal of Medicine article she co-authored examining 40 years of end-of-life policy work. Participants in the hour-long program discussed the ongoing practical and emotional challenges faced by families, patients and physicians when coping with the dying process. The program also featured Dr. Glen Varns, a palliative medicine physician at Allina Health, and Dr. Jacob J. Strand, director of the Mayo Clinic's Symptom Management, Pain and Quality of Life Clinic. A blog post on the topic is available here

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Prof. Wolf on Harvard’s Bill of Health

February 19, 2015

Consortium chair Susan M. Wolf, JD, has posted on Harvard Law School’s Bill of Health about dying in America. Her post, co-authored wit Nancy Berlinger, PhD, and Bruce Jennings, MA, argues that decades of work to fix end-of-life care have failed to make the progress needed. The Canadian Supreme Court’s Feb. 6 decision in Carter v. Canada finds patients still experiencing intolerable suffering and finally throws in the towel, legalizing “physician aid in dying” in Canada. For more from Prof. Wolf and co-authors on this topic, visit the Feb. 12 issue of the New England Journal of Medicine.

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Susan M. Wolf on End-of-Life Care in the New England Journal of Medicine

February 12, 2015

Susan M. Wolf, chair of the Consortium, is lead author of an article in the current issue of the New England Journal of Medicine that gives an overview of four decades of progress -- and outlines what remains to be done -- to improve care at the end of life. Wolf and co-authors Nancy Berlinger and Bruce Jennings also wrote The Hastings Center Guidelines for Decisions on Life-Sustaining Treatment and Care Near the End of Life (Oxford University Press, 2013) a revised and expanded edition of The Hastings Center’s groundbreaking 1987 guidelines.

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Susan Wolf to Present in Atlanta on Death and Dying

October 24, 2013

Professor Susan Wolf will speak on “Improving Care Near the End of Life: Why It's Still So Difficult” at the annual meeting of the American Society for Bioethics and Humanities (ASBH), Oct. 24-27, 2013 in Atlanta. While there, she will also present at the annual meeting of the Hastings Center Fellows.