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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

Withdrawing Life Sustaining Treatment -From Conscious, Non Terminal, Incompetent Part II

8 years ago Bernard W Freedman, JD, MPH 0
  Physician Liability: Withdrawing and Withholding Life Sustaining Care From  Conscious, Non Terminal, Incompetent Patients – Part II There are different standards that must be appreciated and respected before a physician can support a decision to withdraw life sustaining treatment from a non terminal and incompetent patient. This scenario requires the highest degree of protection Read More

Withdrawing Life Sustaining Treatment – Betancourt v Trinitas – Life, Not Policy

9 years ago Bernard W Freedman, JD, MPH 0
Ruben Betancourt, 72 years old, was unconscious following the dislodging of a ventilator breathing tube after surgery at Trinitas Medical Center, which resulted in anoxic encephalopathy. He was readmitted to Trinitas in July 2008 with a diagnosis of renal failure. He received dialysis treatments, remained on a ventilator, and feeding tube. The physicians at Trinitas diagnosed Mr. Betancourt Read More

Funding for physician discussion of end-of life decisions

9 years ago Bernard W Freedman, JD, MPH 0
  Each patient deserves more than a brief discussion about end of life decision-making. In  “A Piece of My Mind” section of this month’s JAMA (volume 303, No.13, April 7, 2010) Paul Kettl M.D. argues for monetary compensation to be provided to physicians for end of life discussion and planning. He fails to make clear, Read More

New York will pass the Family Health Care Decisions Act

9 years ago Bernard W Freedman, JD, MPH 0
 It has been 17 years since this bill was first introduced.   The New York State Senate will pass the Family Health Care Decisions Act (FHCDA), setting forth clear guidelines for family members and others close to the patient to make medical decisions for incapacitated patients. It will also provide physicians with uniform protocols to follow. Read More

Death Panels and Advanced Care Planning

9 years ago Bernard W Freedman, JD, MPH 0
  A recent article in the Journal of the American Medical Association, JAMA, discusses the need for effective public health announcements to encourage people to explain their end of life wishes and their values, goals and preferences. It has been well established that physicians are reluctant to discuss end of life choices with their patients Read More

Doctor’s Mothers and Autonomous Choices

9 years ago Bernard W Freedman, JD, MPH 0
Physicians continue to tell patients what they would do if it were their mother. This is just another form of paternalism and disregard for autonomous decision making. Physicians remain exceedingly reluctant to confront the difficult subject of end of life care. The New York times, on January 11, 2009 published an article, by Denise Grady, Read More

The Proper Role of Bioethics

9 years ago Bernard W Freedman, JD, MPH 0
  In Bioethics we learn that the patient has a right to make autonomous decisions. There has, however, been a bias built into to applicable legislation in many states, which interprets “autonomy” as the dignity to refuse treatment and avoid what is termed a protracted death. This slant on autonomy and the right to refuse treatment can Read More