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Physician assisted death

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https://www.readbyqxmd.com/read/28105542/hospice-in-heart-failure-why-when-and-what-then
#1
Jeffrey L Spiess
Hospice is a model of care for patients nearing the end of their lives that emphasizes symptom management, quality of life (QOL), and support of the patient and caregiving family through the death of the patient and the family's bereavement. It is associated with high patient and caregiver satisfaction and appears to not shorten lifespan for appropriately referred patients. Patients with advanced heart failure are being referred to hospice care more often than in the past, but the majority of deaths occur without this benefit...
January 20, 2017: Heart Failure Reviews
https://www.readbyqxmd.com/read/28098622/physician-assisted-suicide-and-euthanasia-in-the-icu-a-dialogue-on-core-ethical-issues
#2
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/28034580/canadian-cardiovascular-society-canadian-heart-rhythm-society-2016-implantable-cardioverter-defibrillator-guidelines
#3
Matthew Bennett, Ratika Parkash, Pablo Nery, Mario Sénéchal, Blandine Mondesert, David Birnie, Laurence D Sterns, Claus Rinne, Derek Exner, François Philippon, Debra Campbell, Jafna Cox, Paul Dorian, Vidal Essebag, Andrew Krahn, Jaimie Manlucu, Franck Molin, Michael Slawnych, Mario Talajic
Sudden cardiac death is a major public health issue in Canada. However, despite the overwhelming evidence to support the use of implantable cardioverter defibrillators (ICDs) in the prevention of cardiac death there remains significant variability in implantation rates across Canada. Since the most recent Canadian Cardiovascular Society position statement on ICD use in Canada in 2005, there has been a plethora of new scientific information to assist physicians in their discussions with patients considered for ICD implantation to prevent sudden cardiac death due to ventricular arrhythmias...
October 6, 2016: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/28001220/predicting-death-from-kala-azar-construction-development-and-validation-of-a-score-set-and-accompanying-software
#4
Dorcas Lamounier Costa, Regina Lunardi Rocha, Eldo de Brito Ferreira Chaves, Vivianny Gonçalves de Vasconcelos Batista, Henrique Lamounier Costa, Carlos Henrique Nery Costa
INTRODUCTION: Early identification of patients at higher risk of progressing to severe disease and death is crucial for implementing therapeutic and preventive measures; this could reduce the morbidity and mortality from kala-azar. We describe a score set composed of four scales in addition to software for quick assessment of the probability of death from kala-azar at the point of care. METHODS: Data from 883 patients diagnosed between September 2005 and August 2008 were used to derive the score set, and data from 1,031 patients diagnosed between September 2008 and November 2013 were used to validate the models...
November 2016: Revista da Sociedade Brasileira de Medicina Tropical
https://www.readbyqxmd.com/read/27998827/-ebola-kills-generations-qualitative-discussions-with-liberian-healthcare-providers
#5
Sue Anne Bell, Michelle L Munro-Kramer, Marisa C Eisenberg, Garfee Williams, Patricia Amarah, Jody R Lori
OBJECTIVE: the purpose of this study was to explore healthcare providers' perceptions and reactions to the Ebola Virus Disease (EVD) epidemic. DESIGN: a descriptive, qualitative study design was employed. Focus groups were conducted with Liberian healthcare providers who participated in care of patients with EVD. SETTING: the study was conducted in Bong County, Liberia (population: 333,000), which was severely affected, with over 650 reported cases and close to 200 deaths by the end of 2015...
December 9, 2016: Midwifery
https://www.readbyqxmd.com/read/27976497/prospective-and-explicit-clinical-validation-of-the-ottawa-heart-failure-risk-scale-with-and-without-use-of-quantitative-nt-probnp
#6
Ian G Stiell, Jeffrey J Perry, Catherine M Clement, Robert J Brison, Brian H Rowe, Shawn D Aaron, Andrew McRae, Bjug Borgundvaag, Lisa A Calder, Alan J Forster, George A Wells
OBJECTIVES: We previously developed the Ottawa Heart Failure Risk Scale (OHFRS) to assist with disposition decisions for acute heart failure patients in the emergency department (ED). We sought to prospectively evaluate the accuracy, acceptability, and potential impact of OHFRS. METHODS: This prospective observational cohort study was conducted at six tertiary hospital EDs. Patients with acute heart failure were evaluated by ED physicians for the 10 OHFRS criteria and then followed for 30 days...
December 15, 2016: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/27938908/establishing-a-dedicated-general-thoracic-surgery-subspecialty-program-improves-lung-cancer-outcomes
#7
Mitchell J Magee, Morley A Herbert, Lynn Tumey, Syma L Prince
BACKGROUND: Various factors may influence outcomes after lobectomy for lung cancer. Postgraduate subspecialty training in general thoracic surgery with a focus on minimally invasive surgery (MIS) and thoracic oncology was completed by an established cardiothoracic surgeon on the hospital staff in July 2007, and principles emphasized in that training were incorporated into practice through formation of a subspecialty program. We hypothesized that establishing a dedicated general thoracic surgeon-lead subspecialty program, with focus on MIS and thoracic oncology, would improve short-term and long-term outcomes...
December 8, 2016: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/27932271/deactivation-of-left-ventricular-assist-devices-differing-perspectives-of-cardiology-and-hospice-palliative-medicine-clinicians
#8
Colleen K McIlvennan, Sara E Wordingham, Larry A Allen, Daniel D Matlock, Jacqueline Jones, Shannon M Dunlay, Keith M Swetz
BACKGROUND: Beliefs around deactivation of a left ventricular assist device (LVAD) vary substantially between clinicians, institutions, and patients. Therefore, we sought to understand perspectives regarding LVAD deactivation among cardiology and hospice/palliative medicine (HPM) clinicians. METHODS AND RESULTS: We administered a 41-item survey via electronic mail to members of 3 cardiology and 1 HPM professional societies. A convergent parallel mixed methods design was used...
December 5, 2016: Journal of Cardiac Failure
https://www.readbyqxmd.com/read/27905492/high-fidelity-computational-simulation-of-thrombus-formation-in-thoratec-heartmate-ii-continuous-flow-ventricular-assist-device
#9
Wei-Tao Wu, Fang Yang, Jingchun Wu, Nadine Aubry, Mehrdad Massoudi, James F Antaki
Continuous flow ventricular assist devices (cfVADs) provide a life-saving therapy for severe heart failure. However, in recent years, the incidence of device-related thrombosis (resulting in stroke, device-exchange surgery or premature death) has been increasing dramatically, which has alarmed both the medical community and the FDA. The objective of this study was to gain improved understanding of the initiation and progression of thrombosis in one of the most commonly used cfVADs, the Thoratec HeartMate II...
December 1, 2016: Scientific Reports
https://www.readbyqxmd.com/read/27898287/international-association-for-hospice-and-palliative-care-position-statement-euthanasia-and-physician-assisted-suicide
#10
Liliana De Lima, Roger Woodruff, Katherine Pettus, Julia Downing, Rosa Buitrago, Esther Munyoro, Chitra Venkateswaran, Sushma Bhatnagar, Lukas Radbruch
BACKGROUND: Reports about regulations and laws on Euthanasia and Physician Assisted Suicide (PAS) are becoming increasingly common in the media. Many groups have expressed opposition to euthanasia and PAS while those in favor argue that severely chronically ill and debilitated patients have a right to control the timing and manner of their death. Others argue that both PAS and euthanasia are ethically legitimate in rare and exceptional cases. Given that these discussions as well as the new and proposed laws and regulations may have a powerful impact on patients, caregivers, and health care providers, the International Association for Hospice and Palliative Care (IAHPC) has prepared this statement...
January 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/27896390/-assisted-suicide-in-the-movies-what-is-not-shown
#11
Kurt W Schmidt
Whereas changes to the existing legal situation regarding assisted suicide have been a topic of controversial debate in Germany for the last few years, this issue has long been of interest for international film-makers. Since the mid-1980s, the theme of assisted suicide has repeatedly been taken up by cinema, predominantly as central to a relationship drama. A sick person asks somebody close to them for help. Often this somebody is a physician or a nurse, ultimately an obvious way of solving the practical problem of how the assistant is to gain access to a lethal substance...
January 2017: Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz
https://www.readbyqxmd.com/read/27893135/screening-for-colorectal-cancer-and-evolving-issues-for-physicians-and-patients-a-review
#12
REVIEW
David Lieberman, Uri Ladabaum, Marcia Cruz-Correa, Carla Ginsburg, John M Inadomi, Lawrence S Kim, Francis M Giardiello, Richard C Wender
Importance: Colorectal cancer (CRC) is the second-leading cause of cancer death in the United States. Screening can reduce CRC mortality and incidence, and numerous screening options, although available, complicate informed decision making. This review provides evidence-based tools for primary care physicians to identify patients with higher-than-average-risk and engage patients in informed decision making about CRC screening options. Observations: Recently, the US Preventive Services Task Force recommended any of 8 CRC screening approaches for average-risk individuals, beginning at age 50 years...
November 22, 2016: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/27872871/microscopic-medical-image-classification-framework-via-deep-learning-and-shearlet-transform
#13
Hadi Rezaeilouyeh, Ali Mollahosseini, Mohammad H Mahoor
Cancer is the second leading cause of death in US after cardiovascular disease. Image-based computer-aided diagnosis can assist physicians to efficiently diagnose cancers in early stages. Existing computer-aided algorithms use hand-crafted features such as wavelet coefficients, co-occurrence matrix features, and recently, histogram of shearlet coefficients for classification of cancerous tissues and cells in images. These hand-crafted features often lack generalizability since every cancerous tissue and cell has a specific texture, structure, and shape...
October 2016: Journal of Medical Imaging
https://www.readbyqxmd.com/read/27864218/second-primary-malignancies-in-multiple-myeloma-an-overview-and-imwg-consensus
#14
REVIEW
P Musto, K C Anderson, M Attal, P G Richardson, A Badros, J Hou, R Comenzo, J Du, B G M Durie, J San Miguel, H Einsele, W M Chen, L Garderet, G Pietrantuono, J Hillengass, R A Kyle, P Moreau, J J Lahuerta, O Landgren, H Ludwig, A Larocca, A Mahindra, M Cavo, A Mazumder, P L McCarthy, A Nouel, S V Rajkumar, A Reiman, E R Serra, O Sezer, E Terpos, I Turesson, S Usmani, B M Weiss, A Palumbo
BACKGROUND: Therapeutic advancements following the introduction of autologous stem cell transplantation and 'novel' agents have significantly improved clinical outcomes for patients with multiple myeloma (MM). Increased life expectancy, however, has led to renewed concerns about the long-term risk of second primary malignancies (SPMs). This review outlines the most up-to-date knowledge of possible host-, disease-, and treatment-related risk factors for the development of SPMs in patients with MM, and provides practical recommendations to assist physicians...
November 17, 2016: Annals of Oncology: Official Journal of the European Society for Medical Oncology
https://www.readbyqxmd.com/read/27858590/turning-the-tide-or-riptide-the-changing-opioid-epidemic
#15
Stefan G Kertesz
The US opioid epidemic has changed profoundly in the last 3 years, in ways that require substantial recalibration of the US policy response. This report summarizes the changing nature of overdose deaths in Jefferson County (home to Birmingham, Alabama) using data updated through June 30, 2016. Heroin and fentanyl have come to dominate an escalating epidemic of lethal opioid overdose, whereas opioids commonly obtained by prescription play a minor role, accounting for no more than 15% of reported deaths in 2015...
November 18, 2016: Substance Abuse
https://www.readbyqxmd.com/read/27855151/advances-in-the-care-of-children-with-lupus-nephritis
#16
REVIEW
Scott E Wenderfer, Natasha M Ruth, Hermine I Brunner
The care of children with lupus nephritis (LN) has changed dramatically over the past 50 y. The majority of patients with childhood-onset systemic lupus erythematosus (cSLE) develop LN. In the 1960's, prognosis in children was worse than in adults; therapies were limited and toxic. Nearly half of cases resulted in death within 2 y. Since this time, several diagnostic recommendations and disease-specific indices have been developed to assist physicians caring for patients with LN. Pediatric researchers are validating and adapting these indices and guidelines for the treatment of LN in cSLE...
January 4, 2017: Pediatric Research
https://www.readbyqxmd.com/read/27833177/dignity-reevaluated-a-theological-examination-of-human-dignity-and-the-role-of-the-church-in-bioethics-and-end-of-life-care
#17
Quentin I T Genuis
Predominant among the terminological ambiguities that plague contemporary bioethics is confusion attending the meaning of the term "human dignity," particularly as it applies to so-called end-of-life discussions. This study surveys current trends in treatment of the concept of dignity, examining relevant thinkers who see dignity as redundant or as capability-dependent. These inadequate views are contrasted with an attitude, based theologically in Mark 5, that understands human dignity to represent an absolute characteristic that is donated graciously to all bearers of imago Dei...
February 2016: Linacre Quarterly
https://www.readbyqxmd.com/read/27821302/suffering-and-medicalization-at-the-end-of-life-the-case-of-physician-assisted-dying
#18
Hadi Karsoho, Jennifer R Fishman, David Kenneth Wright, Mary Ellen Macdonald
'Suffering' is a central discursive trope for the right-to-die movement. In this article, we ask how proponents of physician-assisted dying (PAD) articulate suffering with the role of medicine at the end of life within the context of a decriminalization and legalization debate. We draw upon empirical data from our study of Carter v. Canada, the landmark court case that decriminalized PAD in Canada in 2015. We conducted in-depth interviews with 42 key participants of the case and collected over 4000 pages of legal documents generated by the case...
October 12, 2016: Social Science & Medicine
https://www.readbyqxmd.com/read/27776894/end-of-life-euthanasia-and-assisted-suicide-an-update-on-the-situation-in-france
#19
REVIEW
R Aubry
On February 2, 2016, the French parliament adopted legislation creating new rights for the terminally ill. The text modifies and reinforces the rights of patients to end-of-life care and strengthens the status of surrogate decision makers. Under the new regulations, advance directives become legally binding though not unenforceable. Two types of advance directives are distinguished depending on whether the person is suffering or not from a serious illness when drafting them. The attending physician must abide by the patient's advance directives except in three situations: there is a life-threatening emergency; the directives are manifestly inappropriate; the directives are not compatible with the patient's medical condition...
December 2016: Revue Neurologique
https://www.readbyqxmd.com/read/27763399/vsed-death-with-dignity-or-without
#20
Mark Corbett
Conceivably, in an ideal world, all patients with a life-limiting illness would receive optimal hospice and palliative care so that no one would ever wish to hasten their own death. The reality, however, is that despite provision of optimal hospice and palliative care, individuals with terminal illness experience suffering, loss of meaning, or deterioration in quality of life to the extent where they express the desire to expedite the dying process. While there has been extensive discussion surrounding physician-assisted death (PAD), there has been less attention paid to the practice of voluntary stopping eating and drinking (VSED) near the end of life...
2016: Narrative Inquiry in Bioethics
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