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

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

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 Near Future – maybe

9 years ago Bernard W Freedman, JD, MPH 0
  New Reform Medical Center Serving your Community since 2010   Agreement and Release   As you enter this Hospital you understand, acknowledge and agree that this hospital rations medical care and services. This means that the hospital and physicians can determine that you may not be entitled to certain medical treatment, even if it Read More

The Case of Baby RM – Court Intervention in Bioethics

9 years ago Bernard W Freedman, JD, MPH 0
  This is the kind of case that courts dread. Baby RM has congenital myasthenic syndrome (CMS) and is on a respirator. The physician supports the mother’s request to terminally extubate. The father implores to the contrary. To make a decision the court must hear evidence, the kind of that will provide a clear picture of Read More

Terminal Extubation: Discussion and Protocol By Bernard Freedman, Bioethicist

10 years ago Bernard W Freedman, JD, MPH 0
  Transparency: The salient ethical, moral and principle necessity to terminal extubation is the transparency of the conduct of all physicians and medical staff, and fundamental understanding by the patient family and or friends as to why it is being done and how it is being done. It is therefore the obligation of the primary Read More

Pay to Play – Cost Containment by Ethics Committees

10 years ago Bernard W Freedman, JD, MPH 0
  The Los Angeles Daily News, July 11, 2009, wrote, “One doctor, who chairs the Northridge Hospital Ethics Committee, did raise the important and relevant issue of excessive, costly, end-of-life care that has no potential for significantly extending life. If consumers had to pay a significant copayment, they might not demand unreasonable or unadvisable care." Read More

A Staged Approach to Withdrawing Life Support

10 years ago Bernard W Freedman, JD, MPH 0
A South Korean Ethics Committee uses a staged approach to Withdrawing Life Support In follow up to this blog’s April 23, 2009 post: “Letting the Conscious But Incompetent, Non Terminally Ill, Patient Die.” A South Korean hospital used a staged approach to consider the withdrawal of artificial life support based upon the condition of the Read More

Daniel Hauser – and Medical Confidentiality

10 years ago Bernard W Freedman, JD, MPH 0
I agree with the court’s rulings in the case of Daniel Hauser, highlighted in the media recently. In this case there is as absolute need to continue chemotherapy. It should however be pointed out that the Court ignored Mrs. Hauser’s demand for confidentiality and contributed to this case becoming a spectacle in the media and Read More