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The Problem with POLST – Physician Orders for Life-Sustaining Treatment

6 years ago Bernard W Freedman, JD, MPH 1
The Problem with POLST Over the years, informed consent has been given short shrift. There is, however, a growing understanding of the importance of obtaining an actual and legitimate consent before  having a patient accept or reject medical treatment. Autonomy, transparency, respect, dignity, and other similarly recognized human rights are increasingly recognized as legal and ethical Read More

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

FCC adopts rules for Medcial Body Area Networks

7 years ago Bernard W Freedman, JD, MPH 0
The FCC adopted rules for Medical Body Area Networks (MBANs), with multiple body-worn sensors “MBAN” that monitor blood glucose, pressure monitoring, electrocardiogram readings, and even neonatal monitoring systems. The monitors can be used in the hospital setting, nursing facilities to identify life-threatening symptoms before they reach critical levels. Under Part 95 of Medical Device “MedRadio” Read More

Same Sex Domestic Partners and Medical Decision Makers

9 years ago Bernard W Freedman, JD, MPH 0
  The Senate Judiciary and Public Affairs committee in New Mexico passed (5 to 4) the Domestic Partnership Bill – 800 pages long that gives unmarried same-sex and opposite-sex couples the legal protections and benefits of married couples on issues including medical decision-making. It is anticipated that republicans will oppose.   It must be made 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

Kidney Transplants and Informed Consent

9 years ago Bernard W Freedman, JD, MPH 0
At the 42d meeting of the American Society of Nephrology in San Diego this week, entitled “Renal Week,” Elisa J. Gordon, PhD, MPH, of Northwestern University presented a study on informed consent, that found that  “kidney transplant consent forms are written at considerably higher reading levels than they should be.” She is of the view 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

Randomized Pediatric Clinical Drug Trials – Africa and America

10 years ago Bernard W Freedman, JD, MPH 0
In 1996, Pfizer needed a randomized trial for a new broad spectrum antibiotic and sent a team of its doctors into the Nigerian slum City of Kano during a meningitis epidemic. It was represented, to be a "humanitarian mission.” A team of Pfizer doctors arrived at the Nigerian camp where meningitis had killed at least Read More