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Waiting for medical records “after discharge” is of no help for decision making

6 years ago Bernard W Freedman, JD, MPH 0
  Medical records: Waiting for medical records “after discharge” is of no help.  Reviewing medical records  in the hospital allows the patient and/or a surrogate decision maker to obtain the greatest amount of information possible over the cross section of medical specialties providing care.  It provides a clear picture of the condition of the patient Read More

Autonomy: the Basis of Respect and Dignity

6 years ago Bernard W Freedman, JD, MPH 0
“Be a good girl and take your medicine.” Part 1 This statement was made to a 60 year old end stage leukemia patient who demanded to be discharged from the hospital. The patient refused the prescribed medications.  No attempt was made to discuss the risks attendant in not taking the prescribed medication. The patient was Read More

Nanotechnology: Who does the EPA Serve?

6 years ago Bernard W Freedman, JD, MPH 0
The 9th Circuit Court of Appeals recently heard oral argument in the case of NATURAL RESOURCES DEFENSE COUNCIL,( NRDC), vs. ENVIRONMENTAL PROTECTION AGENCY, Case# 12-70268, regarding the EPA’s conditional approval of a nano-silver product made by a Swiss company HeiQ Materials. The Amicus briefs describe it as: “ the EPA’s unprecedented decision to conditionally register Read More

Withdrawing Life Sustaining Treatment – End of Life Care: the Doctor-Patient Relationship A Refusal to Communicate

8 years ago Bernard W Freedman, JD, MPH 0
  The New England Journal of Medicine recently published an article entitled: “ The Palliative Care Information Act in Real Life,” (NEJM 364;No.20 May 2011), regarding a New York statute that requires a physician to have discussions of end of life treatment options with the patient when the patient is “terminally ill.” Alan Astrow MD and Read More

Clinical Bioethics – Rationing – the Ethics of Lying to the Patient – Part I

8 years ago Bernard W Freedman, JD, MPH 0
  Rationing : Withholding Medical Care by Lying to the Patient Rationing of medical care and “triage” are different. Triage prioritizes the use of limited medical resources when resources are insufficient for immediate treatment.  Rationing is the withholding of available care for political/economic reasons. With respect to rationing, therefore, it must be decided whether or Read More

Survival in Hospital Cardiac Arrest – Challenges for Hospitalists

9 years ago Bernard W Freedman, JD, MPH 0
The September 2010 publication of “The Hospitalist” reviews the overall survival rates for cardiac arrest patients. This article reports that patients frequently have unrealistic expectations and overestimate their chances of survival. Patients predict post-arrest CPR survival at 64%, while the rate is 17%. Most important is that in nearly half of the patients who initially expressed Read More