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https://www.readbyqxmd.com/read/28975242/ethics-and-the-legalization-of-physician-assisted-suicide-an-american-college-of-physicians-position-paper
#1
Lois Snyder Sulmasy, Paul S Mueller
Calls to legalize physician-assisted suicide have increased and public interest in the subject has grown in recent years despite ethical prohibitions. Many people have concerns about how they will die and the emphasis by medicine and society on intervention and cure has sometimes come at the expense of good end-of-life care. Some have advocated strongly, on the basis of autonomy, that physician-assisted suicide should be a legal option at the end of life. As a proponent of patient-centered care, the American College of Physicians (ACP) is attentive to all voices, including those who speak of the desire to control when and how life will end...
October 17, 2017: Annals of Internal Medicine
https://www.readbyqxmd.com/read/28842220/spiritual-needs-and-perception-of-quality-of-care-and-satisfaction-with-care-in-oncology-patients-a-multi-cultural-assessment
#2
Alan B Astrow, Gary Kwok, Rashmi K Sharma, Nelli Fromer, Daniel P Sulmasy
CONTEXT: Assessment and response to patients' spiritual concerns are crucial components of high quality supportive care. Better measures of spiritual needs across the cultural spectrum may help direct necessary interventions. OBJECTIVES: Assess spiritual needs in a racially/ethnically and religiously mixed sample of hematology and oncology outpatients and examine the association between spiritual needs and perception of quality of care and satisfaction with care...
August 22, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28818632/the-views-of-clergy-regarding-ethical-controversies-in-care-at-the-end-of-life
#3
Michael J Balboni, Adam Sullivan, Patrick T Smith, Danish Zaidi, Christine Mitchell, James A Tulsky, Daniel Sulmasy, Tyler J VanderWeele, Tracy A Balboni
CONTEXT: While religion often informs ethical judgments, little is known about the views of American clergy regarding controversial end-of-life ethical issues including allowing to die and physician-aid in dying or physician-assisted suicide (PAD/PAS). OBJECTIVE: To describe the views of U.S. clergy concerning allowing to die and PAD/PAS. METHODS: A survey was mailed to 1665 nationally representative clergy between 8/2014 to 3/2015 (60% response rate)...
August 14, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28802068/dietary-citrate-and-plasma-ionized-calcium-implications-for-platelet-donors
#4
Stefanie Haynes, Elda Hickson, Jeanne Linden, Patricia St Pierre, Paula Ducharme, Paula Sulmasy, Linda Welch, Yong Zhao, Mindy Greene, Michelle Vauthrin, Robert Weinstein
BACKGROUND: Platelet donors receive 40 mmol or more of IV citrate anion during donation. When plasma ionized calcium ([Ca2+ ]) falls by ∼20%, half of the donors report symptoms of hypocalcemic toxicity. Citrus juices contain clinically relevant amounts of citrate anion. We asked whether citrus juice can lower [Ca2+ ] thus potentially contributing to hypocalcemic toxicity. METHOD: Six volunteers were given 20.4 mmol of citrate anion as grapefruit juice or orange juice...
August 12, 2017: Journal of Clinical Apheresis
https://www.readbyqxmd.com/read/28774957/perceptions-of-control-and-unrealistic-optimism-in-early-phase-cancer-trials
#5
Lynn A Jansen, Daruka Mahadevan, Paul S Appelbaum, William M P Klein, Neil D Weinstein, Motomi Mori, Catherine Degnin, Daniel P Sulmasy
PURPOSE: Recent research has found unrealistic optimism (UO) among patient-subjects in early-phase oncology trials. Our aim was to investigate the cognitive and motivational factors that evoke this bias in this context. We expected perceptions of control to be a strong correlate of unrealistic optimism. METHODS: A study of patient-subjects enrolled in early-phase oncology trials was conducted at two sites in the USA. Respondents completed questionnaires designed to assess unrealistic optimism and several risk attribute variables that have been found to evoke the bias in other contexts...
August 3, 2017: Journal of Medical Ethics
https://www.readbyqxmd.com/read/28728498/variations-in-unrealistic-optimism-between-acceptors-and-decliners-of-early-phase-cancer-trials
#6
Lynn A Jansen, Daruka Mahadevan, Paul S Appelbaum, William M P Klein, Neil D Weinstein, Motomi Mori, Catherine Degnin, Daniel P Sulmasy
Research has found that patient-subjects in early phase cancer trials exhibit unrealistic optimism regarding the risks and possible benefits of trial participation. Unrealistic optimism is associated with therapeutic misconception and failures to appreciate research-related information. This is the first study to assess whether those who decline to participate in these trials also exhibit unrealistic optimism. It is also the first study to assess whether there are significant differences in appreciation of research-related risks/benefits and therapeutic misconception between these two groups...
July 1, 2017: Journal of Empirical Research on Human Research Ethics: JERHRE
https://www.readbyqxmd.com/read/28712987/the-trial-of-ascertaining-individual-preferences-for-loved-ones-role-in-end-of-life-decisions-tailored-study-a-randomized-controlled-trial-to-improve-surrogate-decision-making
#7
Daniel P Sulmasy, Mark T Hughes, Gayane Yenokyan, Joan Kub, Peter B Terry, Alan B Astrow, Julie A Johnson, Grace Ho, Marie T Nolan
CONTEXT: Patients with terminal illnesses often require surrogate decision makers. Prior research has demonstrated high surrogate stress, and that despite standards promoting substituted judgment, most patients do not want their surrogates to make pure substituted judgments for them. It is not known how best to help loved ones fulfill the surrogate role. OBJECTIVES: To test the effectiveness of an intervention to help surrogate decision makers. METHODS: One hundred sixty-six patients (41% with amyotrophic lateral sclerosis and 59% with gastrointestinal cancers) and their surrogates at two university medical centers were randomized to an intensive nurse-directed discussion of the end-of-life decision control preferences of the patient (TAILORED) or a discussion of nutrition (CONTROL); 163 completed baseline interviews and underwent the intervention...
October 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28653765/a-liquid-calcium-vitamin-d3-supplement-is-effective-prophylaxis-against-hypocalcemic-toxicity-during-apheresis-platelet-donation
#8
Robert Weinstein, Stefanie Haynes, Yong Zhao, Elda Hickson, Jeanne Linden, Patricia St Pierre, Paula Ducharme, Paula Sulmasy, Molly Graves, Jeffrey A Bailey, Linda Welch, Amie Simard, Michelle Vauthrin, Mindy Greene
Hypocalcemic toxicity, because of return of citrate anion to the donor, is the major toxicity of apheresis platelet donation. Oral calcium carbonate, given prophylactically at the start of donation, has shown limited ability to alleviate this toxicity. We examined whether repeated prophylactic doses of calcium carbonate, or of a liquid preparation containing calcium citrate, calcium phosphate, and vitamin D3 , would be more effective at preventing symptoms of hypocalcemic toxicity. Symptoms were reported by 48% of donors who received no prophylaxis and 60% of donors who received 1000 mg of oral calcium carbonate at the start of, and every 20 minutes during, donation (P = 0...
June 27, 2017: Journal of Clinical Apheresis
https://www.readbyqxmd.com/read/28543657/ethical-principles-process-and-the-work-of-bioethics-commissions
#9
Daniel P Sulmasy
Shortly after the Presidential Commission for the Study of Bioethical Issues was constituted in 2010 and days before the commission members were to join a conference call to discuss possible topics for their deliberation, Craig Venter held a press conference announcing that his lab had created a synthetic chromosome for a species of mycoplasma and had inserted this genetic material into organisms of another species of mycoplasma (the genes of which had been deactivated), transforming the host species into the donor species...
May 2017: Hastings Center Report
https://www.readbyqxmd.com/read/28473036/ethical-analysis-of-withdrawing-total-artificial-heart-support
#10
Erin S DeMartino, Sara E Wordingham, John M Stulak, Barry A Boilson, Kayla R Fuechtmann, Nausheen Singh, Daniel P Sulmasy, Octavio E Pajaro, Paul S Mueller
OBJECTIVES: To describe the characteristics of patients who undergo withdrawal of total artificial heart support and to explore the ethical aspects of withdrawing this life-sustaining treatment. PATIENTS AND METHODS: We retrospectively reviewed the medical records of all adult recipients of a total artificial heart at Mayo Clinic from the program's inception in 2007 through June 30, 2015. Management of other life-sustaining therapies, approach to end-of-life decision making, engagement of ethics and palliative care consultation, and causes of death were analyzed...
May 2017: Mayo Clinic Proceedings
https://www.readbyqxmd.com/read/28402767/who-decides-when-a-patient-can-t-statutes-on-alternate-decision-makers
#11
Erin S DeMartino, David M Dudzinski, Cavan K Doyle, Beau P Sperry, Sarah E Gregory, Mark Siegler, Daniel P Sulmasy, Paul S Mueller, Daniel B Kramer
Many patients cannot make their own medical decisions, having lost what is called decisional capacity. The estimated prevalence of decisional incapacity approaches 40% among adult medical inpatients and residential hospice patients and exceeds 90% among adults in some intensive care units. Patients..
April 13, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28321550/ethical-implications-of-the-electronic-health-record-in-the-service-of-the-patient
#12
Lois Snyder Sulmasy, Ana María López, Carrie A Horwitch
Electronic health records (EHRs) provide benefits for patients, physicians, and clinical teams, but also raise ethical questions. Navigating how to provide care in the digital age requires an assessment of the impact of the EHR on patient care and the patient-physician relationship. EHRs should facilitate patient care and, as an essential component of that care, support the patient-physician relationship. Billing, regulatory, research, documentation, and administrative functions determined by the operational requirements of health care systems, payers, and others have resulted in EHRs that are better able to satisfy such external functions than to ensure that patient care needs are met...
August 2017: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/28098622/physician-assisted-suicide-and-euthanasia-in-the-icu-a-dialogue-on-core-ethical-issues
#13
Ewan C Goligher, E Wesley Ely, Daniel P Sulmasy, Jan Bakker, John Raphael, Angelo E Volandes, Bhavesh M Patel, Kate Payne, Annmarie Hosie, Larry Churchill, Douglas B White, James Downar
OBJECTIVE: Many patients are admitted to the ICU at or near the end of their lives. Consequently, the increasingly common debate regarding physician-assisted suicide and euthanasia holds implications for the practice of critical care medicine. The objective of this article is to explore core ethical issues related to physician-assisted suicide and euthanasia from the perspective of healthcare professionals and ethicists on both sides of the debate. SYNTHESIS: We identified four issues highlighting the key areas of ethical tension central to evaluating physician-assisted suicide and euthanasia in medical practice: 1) the benefit or harm of death itself, 2) the relationship between physician-assisted suicide and euthanasia and withholding or withdrawing life support, 3) the morality of a physician deliberately causing death, and 4) the management of conscientious objection related to physician-assisted suicide and euthanasia in the critical care setting...
February 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/27934567/tolerance-professional-judgment-and-the-discretionary-space-of-the-physician
#14
Daniel P Sulmasy
Arguments against physicians' claims of a right to refuse to provide tests or treatments to patients based on conscientious objection often depend on two premises that are rarely made explicit. The first is that the protection of religious liberty (broadly construed) should be limited to freedom of worship, assembly, and belief. The second is that because professions are licensed by the state, any citizen who practices a licensed profession is required to provide all the goods and services determined by the profession to fall within the scope of practice of that professional specialty and permitted by the state, regardless of any personal religious, philosophical, or moral objection...
January 2017: Cambridge Quarterly of Healthcare Ethics: CQ: the International Journal of Healthcare Ethics Committees
https://www.readbyqxmd.com/read/27833206/non-faith-based-arguments-against-physician-assisted-suicide-and-euthanasia
#15
Daniel P Sulmasy, John M Travaline, Louise A Mitchell, E Wesley Ely
This article is a complement to "A Template for Non-Religious-Based Discussions Against Euthanasia" by Melissa Harintho, Nathaniel Bloodworth, and E. Wesley Ely which appeared in the February 2015 Linacre Quarterly. Herein we build upon Daniel Sulmasy's opening and closing arguments from the 2014 Intelligence Squared debate on legalizing assisted suicide, supplemented by other non-faith-based arguments and thoughts, providing four nontheistic arguments against physician-assisted suicide and euthanasia: (1) "it offends me"; (2) slippery slope; (3) "pain can be alleviated"; (4) physician integrity and patient trust...
August 2016: Linacre Quarterly
https://www.readbyqxmd.com/read/27755628/euthanasia-and-physician-assisted-suicide
#16
LETTER
Daniel P Sulmasy, E Wesley Ely, Charles L Sprung
No abstract text is available yet for this article.
October 18, 2016: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/27673314/emailing-test-results-to-patients
#17
LETTER
Lois Snyder Sulmasy, Carrie A Horwitch
No abstract text is available yet for this article.
September 27, 2016: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/27472787/justice-courage-and-truthfulness-virtues-that-medical-trainees-can-and-must-learn
#18
Kyle E Karches, Daniel P Sulmasy
Medical educators and powerful physician organizations agree on the importance of professionalism for the formation of good physicians. However, the many definitions of professionalism found in the literature lack content and differ significantly, undermining attempts to describe and implement professionalism curricula. The work of the contemporary moral philosopher Alasdair MacIntyre on the virtues may help provide some of the content that the concept of professionalism currently lacks. MacIntyre shows the importance of the virtues, particularly justice, courage, and truthfulness, for the success of any "practice," defined as a form of cooperative human activity...
July 2016: Family Medicine
https://www.readbyqxmd.com/read/27237410/patient-and-caregiver-characteristics-related-to-completion-of-advance-directives-in-terminally-ill-patients
#19
Grace W K Ho, Lauren Skaggs, Gayane Yenokyan, Anela Kellogg, Julie A Johnson, Mei Ching Lee, Katherine Heinze, Mark T Hughes, Daniel P Sulmasy, Joan Kub, Peter B Terry, Alan B Astrow, Jing Zheng, Lisa Soleymani Lehmann, Marie T Nolan
OBJECTIVE: There is a growing body of literature describing the characteristics of patients who plan for the end of life, but little research has examined how caregivers influence patients' advance care planning (ACP). The purpose of this study was to examine how patient and caregiver characteristics are associated with advance directive (AD) completion among patients diagnosed with a terminal illness. We defined AD completion as having completed a living will and/or identified a healthcare power of attorney...
February 2017: Palliative & Supportive Care
https://www.readbyqxmd.com/read/27034436/decision-making-of-patients-with-implantable-cardioverter-defibrillators-at-end-of-life-family-members-experiences
#20
Mei Ching Lee, Daniel P Sulmasy, Joseph Gallo, Joan Kub, Mark T Hughes, Stuart Russell, Anela Kellogg, Sharon G Owens, Peter Terry, Marie T Nolan
INTRODUCTION: Many patients with advanced heart failure (HF) experience the life-extending benefits of implantable cardioverter-defibrillators (ICD), but at the end stage of HF, patients may experience shocks with increasing frequency and change the plan for end-of-life (EOL) care including the deactivation of the ICD. This report describes family members' experiences of patients with ICD making decisions at EOL. Understanding the decision-making of patients with ICD at EOL can promote informed decision-making and improve the quality of EOL care...
July 2017: American Journal of Hospice & Palliative Care
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