An Examination of Health Care Quality--with a focus on physician rendered caretoabel
This document discusses quality in healthcare and physician-rendered care. It notes that while quality aims to be discernible and reproducible, studies have shown variances in treatment recommendations and outcomes across patient groups. Specifically, a 1999 study found that a patient's race and sex independently influenced physicians' likelihood of recommending cardiac catheterization, indicating potential bias. This raises questions about how physician training and professionalism can allow for differences in care quality among groups. More research is needed to understand what systematic variances in health status are maintained over time for disparate patient populations.
Reducing Marijuana Use and Changing Perceptions about Marijuana Risk Among Co...Kim Petersen
This document discusses marijuana (MJ) use among college students and potential consequences. It notes that MJ use is rising among college students who perceive it as low-risk. However, MJ use can negatively impact students' health, education outcomes, and legal/financial status. College health nurses can use motivational interviewing to help students recognize problems with MJ use and motivate them to reduce harmful behaviors.
Providing safe, affirming and evidence based care for transgender persons: Th...HopkinsCFAR
Tonia Poteat, PhD, PA-C, MPH
Assistant Professor
Johns Hopkins Bloomberg School of Public Health
Jean-Michel Brevelle
Sexual Minorities Program Manager
Maryland Department of Health and Mental Hygiene
Johns Hopkins School of Medicine
August 5, 2016
Developing a cancer survivorship research agenda - Prof Patricia GanzIrish Cancer Society
The document summarizes challenges and opportunities for developing a cancer survivorship research agenda. It notes that the aging population will lead to a large increase in cancer cases and survivors in coming decades. Cancer survivors often face significant physical and mental health issues. More research is needed to understand late effects of treatments and better deliver palliative care, prevention, and health promotion to survivors. Opportunities exist to form interdisciplinary teams, study symptoms and comorbidities, develop safer therapies, and test new models of survivor care. Where to start depends on available populations and expertise. Translational research integrating population health and scientific discovery is key.
Charles William Hinnant Jr. is a urologist and health care attorney currently serving as General Counsel for the American College of Legal Medicine. He received his medical degree from the Medical University of South Carolina and his law degree from Georgia State University. He has over 25 years of experience as a practicing urologist and provides legal consultation services to various medical organizations. He has authored over 30 publications and presentations on topics related to urology, health law, and medical ethics.
COMPROMISSO PARA O CRESCIMENTO, COMPETITIVIDADE E EMPREGOCláudio Carneiro
Este documento discute medidas para promover o crescimento econômico e o emprego em Portugal, incluindo: 1) Apoiar a internacionalização e captação de investimento; 2) Reprogramar o Quadro de Referência Estratégico Nacional e as novas perspectivas financeiras da UE para 2014-2020 para aumentar o foco na competitividade e criação de empregos; 3) Revisar a legislação laboral e promover a negociação coletiva.
Basketball was invented in 1891 by James Naismith. The first official game was played in 1892 at a YMCA gymnasium. Women's basketball began in 1892 at Smith College. The NBA was founded in 1946 and originally had 17 teams, now having 30 teams. Basketball has become popular worldwide with tournaments like the Olympics and FIBA World Cup being important internationally. Countries like Spain, Argentina, and Greece now compete at the same level as the USA national team.
An Examination of Health Care Quality--with a focus on physician rendered caretoabel
This document discusses quality in healthcare and physician-rendered care. It notes that while quality aims to be discernible and reproducible, studies have shown variances in treatment recommendations and outcomes across patient groups. Specifically, a 1999 study found that a patient's race and sex independently influenced physicians' likelihood of recommending cardiac catheterization, indicating potential bias. This raises questions about how physician training and professionalism can allow for differences in care quality among groups. More research is needed to understand what systematic variances in health status are maintained over time for disparate patient populations.
Reducing Marijuana Use and Changing Perceptions about Marijuana Risk Among Co...Kim Petersen
This document discusses marijuana (MJ) use among college students and potential consequences. It notes that MJ use is rising among college students who perceive it as low-risk. However, MJ use can negatively impact students' health, education outcomes, and legal/financial status. College health nurses can use motivational interviewing to help students recognize problems with MJ use and motivate them to reduce harmful behaviors.
Providing safe, affirming and evidence based care for transgender persons: Th...HopkinsCFAR
Tonia Poteat, PhD, PA-C, MPH
Assistant Professor
Johns Hopkins Bloomberg School of Public Health
Jean-Michel Brevelle
Sexual Minorities Program Manager
Maryland Department of Health and Mental Hygiene
Johns Hopkins School of Medicine
August 5, 2016
Developing a cancer survivorship research agenda - Prof Patricia GanzIrish Cancer Society
The document summarizes challenges and opportunities for developing a cancer survivorship research agenda. It notes that the aging population will lead to a large increase in cancer cases and survivors in coming decades. Cancer survivors often face significant physical and mental health issues. More research is needed to understand late effects of treatments and better deliver palliative care, prevention, and health promotion to survivors. Opportunities exist to form interdisciplinary teams, study symptoms and comorbidities, develop safer therapies, and test new models of survivor care. Where to start depends on available populations and expertise. Translational research integrating population health and scientific discovery is key.
Charles William Hinnant Jr. is a urologist and health care attorney currently serving as General Counsel for the American College of Legal Medicine. He received his medical degree from the Medical University of South Carolina and his law degree from Georgia State University. He has over 25 years of experience as a practicing urologist and provides legal consultation services to various medical organizations. He has authored over 30 publications and presentations on topics related to urology, health law, and medical ethics.
COMPROMISSO PARA O CRESCIMENTO, COMPETITIVIDADE E EMPREGOCláudio Carneiro
Este documento discute medidas para promover o crescimento econômico e o emprego em Portugal, incluindo: 1) Apoiar a internacionalização e captação de investimento; 2) Reprogramar o Quadro de Referência Estratégico Nacional e as novas perspectivas financeiras da UE para 2014-2020 para aumentar o foco na competitividade e criação de empregos; 3) Revisar a legislação laboral e promover a negociação coletiva.
Basketball was invented in 1891 by James Naismith. The first official game was played in 1892 at a YMCA gymnasium. Women's basketball began in 1892 at Smith College. The NBA was founded in 1946 and originally had 17 teams, now having 30 teams. Basketball has become popular worldwide with tournaments like the Olympics and FIBA World Cup being important internationally. Countries like Spain, Argentina, and Greece now compete at the same level as the USA national team.
First analasys of title sequence 2 minsDaniel Cooke
The document analyzes the opening credits sequence of the movie Dawn of the Dead, noting the appearance of the Universal Pictures logo at 0:00, followed by visuals and the director credit at 0:05. The title appears at 0:10 and is followed by more visuals and the introduction of the first main actor at 0:17. Music starts at 0:19 and picks up at 0:39 as casting is shown at 1:20 and credits for additional crew like makeup, costumes, producers, and writers follow between 1:20 and 2:29.
El documento describe las diferentes generaciones de computadoras desde la década de 1940 hasta la actualidad. Explica que la primera generación usaba sistemas de procesamiento por lotes sin sistemas operativos y que debían programarse a mano. Las siguientes generaciones introdujeron la multiprogramación, el multiprocesamiento y los sistemas operativos generales. Finalmente, concluye que los sistemas operativos han pasado por un largo proceso de desarrollo y que el tamaño de las computadoras se ha reducido considerablemente desde las primeras máquinas hasta los
1) Rangkaian seri mengalami resonansi pada kapasitor 11,2 μF dengan arus maksimum 19 mA. 2) Rangkaian paralel mengalami resonansi pada kapasitor 176,2 μF dengan arus minimum 400 mA. 3) Data percobaan akan dianalisis lebih lanjut untuk menentukan frekuensi resonansi dan faktor kualitas Q dari kedua rangkaian.
Este documento propõe um programa de governo para a XIII legislatura com o objetivo de virar a página da austeridade e relançar a economia e o emprego. Pretende-se adotar um novo modelo de desenvolvimento baseado no conhecimento e na inovação, defender o estado social e retomar o investimento para promover a convergência com a União Europeia.
La empresa se dedica a la venta de tortas, pastelitos, bebidas y servicios de banquetes y cócteles. Opera desde hace 2 años con un local en La Florida y se especializa en pedidos por teléfono. No cuenta actualmente con sitio web para mostrar sus productos.
Paint.NET comenzó como un proyecto de estudiantes de ingeniería en la Universidad Estatal de Washington en 2004, y proporciona herramientas para editar imágenes como capas, ajustes de brillo y contraste, efectos y un historial de ediciones. Ofrece paneles rápidos de herramientas, colores, historial y capas para facilitar la edición de imágenes.
1) A Sun é uma empresa de tecnologia fundada em 1982 com mais de 33.000 empregados e escritórios em mais de 100 países.
2) A Sun é comprometida com comunidades abertas e livres, sendo o maior contribuidor comercial para projetos de código aberto, com US$2 bilhões em contribuições.
3) O documento discute os princípios e benefícios do código aberto, a importância da participação em projetos de código aberto e as oportunidades para estudantes através da iniciativa ac
This document provides information about Australia's economy and key industries. It discusses Australia's comparative advantage in mining and absolute advantage in agriculture. Mining is a major industry for Australia and contributes significantly to its GDP and exports. Gold mining during gold rushes in the 1800s greatly increased Australia's population and wealth. Australia has abundant natural resources and is a major global exporter of minerals including iron ore, coal, bauxite, gold, uranium and diamonds.
Este documento contém várias portarias que (1) concedem canais de frequência para transmissão digital de televisão a empresas de retransmissão de sinal em diferentes localidades, e (2) aprovam propostas de empresas de incluir pacotes de aplicativos desenvolvidos no Brasil em smartphones para obter desoneração fiscal.
The document discusses physician-assisted suicide laws in several US states. It provides details on:
1) The eligibility requirements for patients seeking physician-assisted suicide, including being terminally ill with less than 6 months to live, mentally competent, and a resident of Oregon, Washington, Vermont, Montana or New Mexico.
2) The process patients must go through, including making two oral requests 15 days apart, a written request, and a 48-hour waiting period before receiving a prescription.
3) Perspectives on the debate around physician-assisted suicide laws, with supporters arguing for patient autonomy and relieving suffering, and opponents like the Catholic Church believing it devalues life.
Roebuck 1 Brittany Roebuck Professor Bertsch ENG.docxhealdkathaleen
Roebuck 1
Brittany Roebuck
Professor Bertsch
ENGL 1100
8 April 2018
Should Physician-Assisted Suicide Be Legal?
In 1997, Oregon became the first state to enact the Death with Dignity Act (DWDA).
This act allows a person with a terminal illness to make the decision to end their own life with a
lethal medication prescribed by a physician. Since then, only four other states have legalized
physician-assisted suicide. I’m interested in this topic for two reasons. The first being I am
currently making a career change and going back to school for nursing. I ultimately want to
become a hospice nurse. I believe this is a very relevant topic in the field of providing comfort
care to terminally ill patients. The second reason is because my grandpa died of lung cancer and I
spent the majority of his last three months taking care of him. His time between diagnosis and
when he passed was very quick but also very painful. I can’t imagine if he had lived for another
year or more how difficult it would have been for him, myself, and my family. We never
discussed the option of physician-assisted suicide because it is not an option in the state of Ohio.
My grandpa had a passion for life and living it to the fullest. Knowing him well, I think if the
option had been available, it would have been something he would have considered. I wanted to
dive into this topic and find out why in the past eleven years this law has only been passed in five
states. So, I decided to do some research of my own to find out the answer to my question:
Should physician-assisted suicide be legal in every state?
When I started researching this topic, I found a lot of opposition. There are many reasons
people are against physician-assisted suicide. One being religious reasons. Religious
Roebuck 2
organizations argue that human life is sacred and someone ending their own life, no matter the
circumstances, is morally and spiritually wrong (“Right to Die” 2). The American Medical
Association also objects to physician-assisted suicide. They argue that physicians are meant to
heal not kill (2). Another argument states that allowing physician-assisted suicide would leave
people with mental and physical disabilities open to being coerced into ending their own lives. If
someone believes they may be a financial or physical burden on their family, they may be
tempted to consider physician-assisted suicide simply to relieve that burden. Some people think
instead of helping people die, doctors and policy makers should be working on improving end-
of-life care (2). There is also an argument that minorities have less access to health care and
receive less treatment as a result. This may make a pill to end their lives feel like the only option
for them. (2)
As far as support for this movement, well, there’s less of it. Supporters argue that if a
person has the right to refuse medical treatment, they should also have the rig ...
This document discusses patient autonomy and physician obligations at end of life. It examines two case studies of young women with terminal illnesses who are maintaining autonomy in different ways. Brittany Maynard is moving to Oregon to pursue physician assisted suicide, while Lauren Hill focuses on raising cancer awareness and playing basketball. The document argues that physicians should support patient choices to die with dignity as long as they are competent. It also stresses the importance of advance care planning and conversations with loved ones to ensure wishes are followed.
The document argues against physician aided suicide (PAS) or euthanasia for several reasons. It states that modern medicine can effectively manage pain and end of life care without hastening death. It also argues that PAS could become overused for health care cost containment and that some may choose it due to depression rather than medical necessity. Finally, it maintains that allowing PAS could start society down a slippery slope where laws are abused or people feel pressured to end their lives prematurely.
The document argues against physician aided suicide (PAS) or euthanasia for several reasons. It states that modern medicine can effectively manage pain and end of life care without hastening death. It also argues that PAS could become overused for health care cost containment and that some may choose it due to depression rather than medical necessity. Finally, it maintains that allowing PAS could start society down a slippery slope where human life is devalued.
This document discusses euthanasia and its legal status in various countries and US states. It defines euthanasia as intentionally ending a person's life to alleviate pain and suffering, and identifies three types: voluntary, non-voluntary, and involuntary. Several landmark court cases related to end-of-life decisions and removing life support are also summarized. Both arguments for and against euthanasia are presented, focusing on patient autonomy versus the ethical responsibilities of medical professionals.
Physician Assisted Death
Alexandra Preston
HSA4431
What is Physician Assisted Death?
One may ask what is Physician Assisted Death, its the act of a physician intentionally providing a patient with the means necessary to commit suicide, which can include counseling about lethal doses of drugs, prescribing lethal doses or supplying the drugs.
Interesting Background About Physician Assisted Death
There are only 5 states where physician assisted death is legal ( Oregon, Washington, Montana, Vermont, California)
Oregon was the First State to allow Physician assisted Death on November 8, 1994
California was the most recent to legalize it on October 5, 2015
Montana is the only state where it could be mandated by court ruling for a physician to be able to proceed with assisting a patient to die.
The specific method in which assisted death is done in each state varies, but mainly involves a prescription from a licensed physician approved by the state in which the patient is a resident.
Difference Between Physician Assisted Death and Euthanasia
Although they may have similar goals, physician-assisted suicide and euthanasia differ
In Physician-Assisted Suicide:
The physician provides the necessary means or information
The patient performs the act
In Euthanasia: The physician performs the intervention
Euthanasia is defined as the act of bringing about the death of a hopelessly ill and suffering person in a relatively quick and painless way for reasons of mercy
Timeline of Physician Assisted Death
June 1997 - The U.S. Supreme Court rules that state laws banning physician-assisted suicide do not violate the Constitution in the case Washington v. Glucksberg. The court left the matter of the constitutionality of a right to a physician's aid in dying to the states.
October 27, 1997 - Oregon's Death with Dignity Act becomes law. Passed in a 1994 election with 51% of voters in favor, the law was delayed initially because U.S. District Judge Michael Hogan issued an injunction and then ruled it unconstitutional. The Ninth Circuit Court of Appeals reversed the ruling and the injunction was lifted when the U.S. Supreme Court referred the matter back to the state in 1997.
November 1998 - American pathologist and assisted suicide advocate Jack Kevorkian, known as "Dr. Death," videotapes the death of Thomas Youk, submits it to CBS's 60 Minutes and it is broadcast on television. The airing prompts murder charges against Kevorkian, rather than assisted suicide charges, because Kevorkian injected the drug into Youk, who had Lou Gehrig's disease.
March 26, 1999 - Kevorkian is convicted of second degree murder and delivery of a controlled substance. He serves eight years of a 10 to 25 year sentence. November 4, 2008 - Washington's initiative, the Death with Dignity Act, is passed with 57.91% of voters in favor. March 5, 2009 - The Washington Death with Dignity Act goes into effect.
Timeline cont’d
December 31, 2009 - A Montana Supreme Cou ...
1) The document discusses a debate between Professor Joe Collier who argues for legalizing assisted dying and Professor John Wyatt who argues against it.
2) Collier believes that terminally ill, mentally competent adults should have the choice of an assisted death with proper safeguards. He cites surveys showing most people support this and claims assisted dying already covertly happens.
3) Wyatt disagrees and argues that introducing death goes against the Hippocratic oath for doctors to heal. He believes it is difficult to truly assess mental competence and coercion, and that better palliative care is needed instead of assisted dying.
PerspectiveRedefining Physicians Role in Assisted DyingJulian.docxssuser562afc1
Perspective
Redefining Physicians' Role in Assisted Dying
Julian J.Z. Prokopetz, B.A., and Lisa Soleymani Lehmann, M.D., Ph.D.
N Engl J Med 2012; 367:97-99July 12, 2012
Interview with Dr. Lisa Lehmann on the physician’s role in assisted dying for terminally ill patients. (16:20)
· Listen
· Download
Terminally ill patients spend their final months making serious decisions about medical care and the disposition of their assets after death. Increasingly, they are also choosing to make decisions about the manner and timing of their death, and many are completing advance directives to withhold life-sustaining treatment. A controversial facet of this trend toward a more self-directed dying process is the question of assisted dying — whether patients should have the option of acquiring a lethal dose of medication with the explicit intention of ending their own life.
This practice is generally illegal, but there is a movement toward greater social and legal acceptance. The Netherlands had a long history of court-regulated assisted dying before official legislative recognition, and some Western European countries have followed its lead. Oregon became the first U.S. state to legalize assisted dying when it passed the Death with Dignity Act (DWDA) through a voter referendum in 1997. Since 2008, six states have considered the issue legislatively or judicially; although legalization efforts failed in New Hampshire, Hawaii, New York, and Connecticut, they succeeded in Washington State (through a referendum) and Montana (through a court ruling). Measures based on the DWDA are up for consideration in Pennsylvania and Vermont, and Massachusetts supporters are working toward a ballot measure. Independent governmental commissions in Canada and Britain have recommended legalization, and the Supreme Court of British Columbia recently struck down a national ban on physician-assisted suicide.
Data from places with legal assisted dying have helped allay concerns about potential abuses and patient safety, but a lingering challenge comes from the medical establishment. Many medical professionals are uncomfortable with the idea of physicians playing an active role in ending patients' lives,1 and the American Medical Association (AMA) and various state medical groups oppose legalization. This position is not an insurmountable barrier, however; we propose a system that would remove the physician from direct involvement in the process.
Advances in palliative medicine have produced effective strategies for managing and relieving pain for most terminally ill patients, including the possibility of palliative sedation. Inadequate pain control therefore ranks among the least common reasons that patients in Oregon request lethal medication. Most say that they are motivated by a loss of autonomy and dignity and an inability to engage in activities that give their life meaning.2 Patients in the United States may already decline to receive life-sustaining treatment through advan.
This document discusses perspectives on assisted suicide from multiple sources. It begins by outlining arguments for and against physician-assisted suicide. Proponents argue that individuals should be able to control their lives and death, and that assisted suicide can relieve unbearable suffering. Opponents counter that taking a life is immoral, the practice is open to abuse, and it undermines the medical profession. The document then provides an overview of laws regarding assisted suicide in various countries and regions including the US, Canada, Mexico, the UK, and parts of Europe.
First analasys of title sequence 2 minsDaniel Cooke
The document analyzes the opening credits sequence of the movie Dawn of the Dead, noting the appearance of the Universal Pictures logo at 0:00, followed by visuals and the director credit at 0:05. The title appears at 0:10 and is followed by more visuals and the introduction of the first main actor at 0:17. Music starts at 0:19 and picks up at 0:39 as casting is shown at 1:20 and credits for additional crew like makeup, costumes, producers, and writers follow between 1:20 and 2:29.
El documento describe las diferentes generaciones de computadoras desde la década de 1940 hasta la actualidad. Explica que la primera generación usaba sistemas de procesamiento por lotes sin sistemas operativos y que debían programarse a mano. Las siguientes generaciones introdujeron la multiprogramación, el multiprocesamiento y los sistemas operativos generales. Finalmente, concluye que los sistemas operativos han pasado por un largo proceso de desarrollo y que el tamaño de las computadoras se ha reducido considerablemente desde las primeras máquinas hasta los
1) Rangkaian seri mengalami resonansi pada kapasitor 11,2 μF dengan arus maksimum 19 mA. 2) Rangkaian paralel mengalami resonansi pada kapasitor 176,2 μF dengan arus minimum 400 mA. 3) Data percobaan akan dianalisis lebih lanjut untuk menentukan frekuensi resonansi dan faktor kualitas Q dari kedua rangkaian.
Este documento propõe um programa de governo para a XIII legislatura com o objetivo de virar a página da austeridade e relançar a economia e o emprego. Pretende-se adotar um novo modelo de desenvolvimento baseado no conhecimento e na inovação, defender o estado social e retomar o investimento para promover a convergência com a União Europeia.
La empresa se dedica a la venta de tortas, pastelitos, bebidas y servicios de banquetes y cócteles. Opera desde hace 2 años con un local en La Florida y se especializa en pedidos por teléfono. No cuenta actualmente con sitio web para mostrar sus productos.
Paint.NET comenzó como un proyecto de estudiantes de ingeniería en la Universidad Estatal de Washington en 2004, y proporciona herramientas para editar imágenes como capas, ajustes de brillo y contraste, efectos y un historial de ediciones. Ofrece paneles rápidos de herramientas, colores, historial y capas para facilitar la edición de imágenes.
1) A Sun é uma empresa de tecnologia fundada em 1982 com mais de 33.000 empregados e escritórios em mais de 100 países.
2) A Sun é comprometida com comunidades abertas e livres, sendo o maior contribuidor comercial para projetos de código aberto, com US$2 bilhões em contribuições.
3) O documento discute os princípios e benefícios do código aberto, a importância da participação em projetos de código aberto e as oportunidades para estudantes através da iniciativa ac
This document provides information about Australia's economy and key industries. It discusses Australia's comparative advantage in mining and absolute advantage in agriculture. Mining is a major industry for Australia and contributes significantly to its GDP and exports. Gold mining during gold rushes in the 1800s greatly increased Australia's population and wealth. Australia has abundant natural resources and is a major global exporter of minerals including iron ore, coal, bauxite, gold, uranium and diamonds.
Este documento contém várias portarias que (1) concedem canais de frequência para transmissão digital de televisão a empresas de retransmissão de sinal em diferentes localidades, e (2) aprovam propostas de empresas de incluir pacotes de aplicativos desenvolvidos no Brasil em smartphones para obter desoneração fiscal.
The document discusses physician-assisted suicide laws in several US states. It provides details on:
1) The eligibility requirements for patients seeking physician-assisted suicide, including being terminally ill with less than 6 months to live, mentally competent, and a resident of Oregon, Washington, Vermont, Montana or New Mexico.
2) The process patients must go through, including making two oral requests 15 days apart, a written request, and a 48-hour waiting period before receiving a prescription.
3) Perspectives on the debate around physician-assisted suicide laws, with supporters arguing for patient autonomy and relieving suffering, and opponents like the Catholic Church believing it devalues life.
Roebuck 1 Brittany Roebuck Professor Bertsch ENG.docxhealdkathaleen
Roebuck 1
Brittany Roebuck
Professor Bertsch
ENGL 1100
8 April 2018
Should Physician-Assisted Suicide Be Legal?
In 1997, Oregon became the first state to enact the Death with Dignity Act (DWDA).
This act allows a person with a terminal illness to make the decision to end their own life with a
lethal medication prescribed by a physician. Since then, only four other states have legalized
physician-assisted suicide. I’m interested in this topic for two reasons. The first being I am
currently making a career change and going back to school for nursing. I ultimately want to
become a hospice nurse. I believe this is a very relevant topic in the field of providing comfort
care to terminally ill patients. The second reason is because my grandpa died of lung cancer and I
spent the majority of his last three months taking care of him. His time between diagnosis and
when he passed was very quick but also very painful. I can’t imagine if he had lived for another
year or more how difficult it would have been for him, myself, and my family. We never
discussed the option of physician-assisted suicide because it is not an option in the state of Ohio.
My grandpa had a passion for life and living it to the fullest. Knowing him well, I think if the
option had been available, it would have been something he would have considered. I wanted to
dive into this topic and find out why in the past eleven years this law has only been passed in five
states. So, I decided to do some research of my own to find out the answer to my question:
Should physician-assisted suicide be legal in every state?
When I started researching this topic, I found a lot of opposition. There are many reasons
people are against physician-assisted suicide. One being religious reasons. Religious
Roebuck 2
organizations argue that human life is sacred and someone ending their own life, no matter the
circumstances, is morally and spiritually wrong (“Right to Die” 2). The American Medical
Association also objects to physician-assisted suicide. They argue that physicians are meant to
heal not kill (2). Another argument states that allowing physician-assisted suicide would leave
people with mental and physical disabilities open to being coerced into ending their own lives. If
someone believes they may be a financial or physical burden on their family, they may be
tempted to consider physician-assisted suicide simply to relieve that burden. Some people think
instead of helping people die, doctors and policy makers should be working on improving end-
of-life care (2). There is also an argument that minorities have less access to health care and
receive less treatment as a result. This may make a pill to end their lives feel like the only option
for them. (2)
As far as support for this movement, well, there’s less of it. Supporters argue that if a
person has the right to refuse medical treatment, they should also have the rig ...
This document discusses patient autonomy and physician obligations at end of life. It examines two case studies of young women with terminal illnesses who are maintaining autonomy in different ways. Brittany Maynard is moving to Oregon to pursue physician assisted suicide, while Lauren Hill focuses on raising cancer awareness and playing basketball. The document argues that physicians should support patient choices to die with dignity as long as they are competent. It also stresses the importance of advance care planning and conversations with loved ones to ensure wishes are followed.
The document argues against physician aided suicide (PAS) or euthanasia for several reasons. It states that modern medicine can effectively manage pain and end of life care without hastening death. It also argues that PAS could become overused for health care cost containment and that some may choose it due to depression rather than medical necessity. Finally, it maintains that allowing PAS could start society down a slippery slope where laws are abused or people feel pressured to end their lives prematurely.
The document argues against physician aided suicide (PAS) or euthanasia for several reasons. It states that modern medicine can effectively manage pain and end of life care without hastening death. It also argues that PAS could become overused for health care cost containment and that some may choose it due to depression rather than medical necessity. Finally, it maintains that allowing PAS could start society down a slippery slope where human life is devalued.
This document discusses euthanasia and its legal status in various countries and US states. It defines euthanasia as intentionally ending a person's life to alleviate pain and suffering, and identifies three types: voluntary, non-voluntary, and involuntary. Several landmark court cases related to end-of-life decisions and removing life support are also summarized. Both arguments for and against euthanasia are presented, focusing on patient autonomy versus the ethical responsibilities of medical professionals.
Physician Assisted Death
Alexandra Preston
HSA4431
What is Physician Assisted Death?
One may ask what is Physician Assisted Death, its the act of a physician intentionally providing a patient with the means necessary to commit suicide, which can include counseling about lethal doses of drugs, prescribing lethal doses or supplying the drugs.
Interesting Background About Physician Assisted Death
There are only 5 states where physician assisted death is legal ( Oregon, Washington, Montana, Vermont, California)
Oregon was the First State to allow Physician assisted Death on November 8, 1994
California was the most recent to legalize it on October 5, 2015
Montana is the only state where it could be mandated by court ruling for a physician to be able to proceed with assisting a patient to die.
The specific method in which assisted death is done in each state varies, but mainly involves a prescription from a licensed physician approved by the state in which the patient is a resident.
Difference Between Physician Assisted Death and Euthanasia
Although they may have similar goals, physician-assisted suicide and euthanasia differ
In Physician-Assisted Suicide:
The physician provides the necessary means or information
The patient performs the act
In Euthanasia: The physician performs the intervention
Euthanasia is defined as the act of bringing about the death of a hopelessly ill and suffering person in a relatively quick and painless way for reasons of mercy
Timeline of Physician Assisted Death
June 1997 - The U.S. Supreme Court rules that state laws banning physician-assisted suicide do not violate the Constitution in the case Washington v. Glucksberg. The court left the matter of the constitutionality of a right to a physician's aid in dying to the states.
October 27, 1997 - Oregon's Death with Dignity Act becomes law. Passed in a 1994 election with 51% of voters in favor, the law was delayed initially because U.S. District Judge Michael Hogan issued an injunction and then ruled it unconstitutional. The Ninth Circuit Court of Appeals reversed the ruling and the injunction was lifted when the U.S. Supreme Court referred the matter back to the state in 1997.
November 1998 - American pathologist and assisted suicide advocate Jack Kevorkian, known as "Dr. Death," videotapes the death of Thomas Youk, submits it to CBS's 60 Minutes and it is broadcast on television. The airing prompts murder charges against Kevorkian, rather than assisted suicide charges, because Kevorkian injected the drug into Youk, who had Lou Gehrig's disease.
March 26, 1999 - Kevorkian is convicted of second degree murder and delivery of a controlled substance. He serves eight years of a 10 to 25 year sentence. November 4, 2008 - Washington's initiative, the Death with Dignity Act, is passed with 57.91% of voters in favor. March 5, 2009 - The Washington Death with Dignity Act goes into effect.
Timeline cont’d
December 31, 2009 - A Montana Supreme Cou ...
1) The document discusses a debate between Professor Joe Collier who argues for legalizing assisted dying and Professor John Wyatt who argues against it.
2) Collier believes that terminally ill, mentally competent adults should have the choice of an assisted death with proper safeguards. He cites surveys showing most people support this and claims assisted dying already covertly happens.
3) Wyatt disagrees and argues that introducing death goes against the Hippocratic oath for doctors to heal. He believes it is difficult to truly assess mental competence and coercion, and that better palliative care is needed instead of assisted dying.
PerspectiveRedefining Physicians Role in Assisted DyingJulian.docxssuser562afc1
Perspective
Redefining Physicians' Role in Assisted Dying
Julian J.Z. Prokopetz, B.A., and Lisa Soleymani Lehmann, M.D., Ph.D.
N Engl J Med 2012; 367:97-99July 12, 2012
Interview with Dr. Lisa Lehmann on the physician’s role in assisted dying for terminally ill patients. (16:20)
· Listen
· Download
Terminally ill patients spend their final months making serious decisions about medical care and the disposition of their assets after death. Increasingly, they are also choosing to make decisions about the manner and timing of their death, and many are completing advance directives to withhold life-sustaining treatment. A controversial facet of this trend toward a more self-directed dying process is the question of assisted dying — whether patients should have the option of acquiring a lethal dose of medication with the explicit intention of ending their own life.
This practice is generally illegal, but there is a movement toward greater social and legal acceptance. The Netherlands had a long history of court-regulated assisted dying before official legislative recognition, and some Western European countries have followed its lead. Oregon became the first U.S. state to legalize assisted dying when it passed the Death with Dignity Act (DWDA) through a voter referendum in 1997. Since 2008, six states have considered the issue legislatively or judicially; although legalization efforts failed in New Hampshire, Hawaii, New York, and Connecticut, they succeeded in Washington State (through a referendum) and Montana (through a court ruling). Measures based on the DWDA are up for consideration in Pennsylvania and Vermont, and Massachusetts supporters are working toward a ballot measure. Independent governmental commissions in Canada and Britain have recommended legalization, and the Supreme Court of British Columbia recently struck down a national ban on physician-assisted suicide.
Data from places with legal assisted dying have helped allay concerns about potential abuses and patient safety, but a lingering challenge comes from the medical establishment. Many medical professionals are uncomfortable with the idea of physicians playing an active role in ending patients' lives,1 and the American Medical Association (AMA) and various state medical groups oppose legalization. This position is not an insurmountable barrier, however; we propose a system that would remove the physician from direct involvement in the process.
Advances in palliative medicine have produced effective strategies for managing and relieving pain for most terminally ill patients, including the possibility of palliative sedation. Inadequate pain control therefore ranks among the least common reasons that patients in Oregon request lethal medication. Most say that they are motivated by a loss of autonomy and dignity and an inability to engage in activities that give their life meaning.2 Patients in the United States may already decline to receive life-sustaining treatment through advan.
This document discusses perspectives on assisted suicide from multiple sources. It begins by outlining arguments for and against physician-assisted suicide. Proponents argue that individuals should be able to control their lives and death, and that assisted suicide can relieve unbearable suffering. Opponents counter that taking a life is immoral, the practice is open to abuse, and it undermines the medical profession. The document then provides an overview of laws regarding assisted suicide in various countries and regions including the US, Canada, Mexico, the UK, and parts of Europe.
This document discusses perspectives on assisted suicide from multiple sources. It begins by outlining arguments for and against physician-assisted suicide. Proponents argue that individuals should be able to control their lives and death can relieve unbearable suffering. Opponents counter that taking a life is immoral, the practice is open to abuse, and it undermines the medical profession. The document then provides an overview of laws regarding assisted suicide in various countries and regions including the US, Canada, Mexico, UK, and parts of Europe. It notes places where assisted suicide is legal and illegal as well as differences in allowing passive vs active euthanasia.
Physician-assisted suicide is a controversial issue that is only legal in five U.S. states. It allows terminally ill patients with less than six months to live to request lethal medication from their doctor to end their own lives. While some see it as giving patients control at the end of life, others argue it could encourage suicide or that terminally ill patients are not in a mental state to make such a decision. There are also concerns about how to protect vulnerable patients from being coerced into suicide. The document discusses the various perspectives on this complex issue and argues rules need to be put in place to allow physician-assisted suicide as an option while also protecting doctors' and patients' rights.
After reading the Brittany Maynard case, create an original post tha.docxneedhamserena
After reading the Brittany Maynard case, create an original post that compares your professional and personal positions on the case. What are the code of ethics, professional regulations, and policies that support your professional position? Explain how to work through ideas when your professional and personal positions come into conflict.
California legislators just introduced a bill to let the terminally ill end their own lives
photo-color: Debbie Ziegler, the mother of Brittany Maynard, speaks in support of proposed legislation allowing doctors to prescribe life-ending medication to terminally ill patients during a news conference at the Capitol, Jan. 21, 2015, in Sacramento, Calif. Rich Pedroncelli—AP
After Brittany Maynard was diagnosed with terminal brain cancer last year, she decided to move from California, where she was born and raised, to Oregon. She chose it because Oregon was one of just five states in the nation that allowed Maynard to obtain medication to end her own life.
Since Maynard’s death in November, six states have introduced so-called right-to-die legislation, including the one she chose to leave.
“The fact that Brittany Maynard was a Californian suffering from an incurable, irreversible illness who then had to leave the state to ease her suffering was simply appalling, simply unacceptable,” says California Sen. Lois Wolk, who along with Sen. Bill Monning, both Democrats, have co-authored a bill giving terminally ill patients with six months to live the ability to obtain life-ending medication.
The bill, which would require two independent physicians to determine that patients are mentally competent to make an end-of-life decision, is largely modeled after Oregon’s 1997 Death With Dignity law, which was the first state measure to allow terminal patients to end their lives. That law has become a template for other states considering similar legislation. According to the Oregon Public Health Division, 1,173 people have had end-of-life medication prescribed to them as of 2013; 752 have actually chosen to ingest it.
Only two other states have passed right-to-die legislation—Washington and Vermont—while judges in New Mexico and Montana have effectively legalized it by saying there is nothing barring doctors from prescribing life-ending medication.
For years, the so-called right-to-die movement was most associated with Jack Kevorkian, the Michigan physician known as Dr. Death for participating in dozens of physician-assisted suicides, one of which led to a conviction of second-degree murder. Maynard offered a far more sympathetic face for the movement. A 29-year-old newlywed who was diagnosed with brain cancer on Jan. 1, 2014, Maynard used her story to advocate for so-called death with dignity laws while publicly discussing her symptoms and plans for her last few weeks. She died Nov. 1 after taking doctor-prescribed barbiturates.
Since then, legislators from 14 states have either introduced or pledged to put forwa ...
The document discusses the right to die debate, including arguments from both supporters and opponents. It provides details on Oregon's Death with Dignity Act, the first law in the US to legalize physician-assisted suicide. The act established requirements like being diagnosed with a terminal illness, making two oral requests separated by 15 days, and undergoing a psychological evaluation if concerns about the patient's ability to consent arise. It also discusses a related 2006 Supreme Court case upholding the law and euthanasia practices in Switzerland that allow "suicide tourism."
Similar to Medical Marijuana Patients In California Are Being Denied Organ Transplants, But That Could Soon Change (15)
Medical Marijuana Patients In California Are Being Denied Organ Transplants, But That Could Soon Change
1. Medical Marijuana Patients In California Are Being Denied
Organ Transplants, But That Could Soon Change
Justin Turley has suffered from cirrhosis, a degenerative liver disorder that keeps him in near-
constant pain, for 13 years. Shortly after his diagnosis, frustrated by the side effects of
pharmaceutical medications he said turned him into a "zombie," he started using medical marijuana
to treat his symptoms.
"I was able to eat again; I could deal with the pain and not have to be completely removed from
social situations," the San Diego resident told The Huffington Post. "It helped me alleviate my
problems without all the complications."
Turley's doctor told him that he would eventually need a liver transplant in order to survive, so he
scheduled an appointment at University of California San Diego Medical Center to learn more.
There, he unabashedly told the physician evaluating him that he used medical marijuana in
accordance with California's state law, which passed in 1996. She replied that as long as he
continued to use cannabis, he would be kept off the transplant list.
"I volunteered the information," Turley said, adding that the doctor who wrote his medical marijuana
recommendation had lectured at UCSD in the past about using cannabis to treat pain. "I didn't
realize this was a taboo subject. I'm a legal patient."
Justin Turley was told he would be kept off the list for a liver transplant as long as he continues to
use marijuana.
Turley is one of what advocacy group Americans for Safe Access estimates to be hundreds of
medical marijuana patients throughout California being denied organ transplants that could save
their lives. But that may soon change. Earlier this month, Assemblymember Marc Levine (D)
introduced legislation that would explicitly protect these patients from being kept off transplant lists
because of their cannabis use.
2. "It's incredibly unfair that people who are following the rules, who are deathly ill and trying to
relieve their symptoms, are suddenly denied an organ transplant," Levine said. "There's no medical
reason why these patients should be stigmatized or denied a life-saving opportunity."
Six other states where medical marijuana is permitted have adopted laws that protect transplant-
seeking patients from discrimination because they treat their symptoms with cannabis. Similarly,
Levine's bill would expand an existing California law, which states that officials can't use mental or
physical disabilities to determine a patient's eligibility for receiving an organ transplant, by adding
medical marijuana use to the list of protections.
"There are uniform policies in place surrounding organ transplants, and these policies predate
medical marijuana," said Don Duncan, the director of the California chapter of Americans for Safe
Access. "It's not a drug issue; it's an access to health care issue. More people will live if we pass this
law."
Because there's no official law on the books, hospitals and medical centers in California are left to
their own devices when it comes to writing and implementing policies that affect patients who use
medical marijuana. Doctors at UCSD, for example, have repeatedly denied Turley's requests to be
added to the liver transplant waiting list, and never elaborated as to their reasoning.
Tim Garon was a Seattle cancer patient who died in 2008 after being denied a liver transplant
because he was using medical marijuana.
"It's like talking to a brick wall," Turley said. UCSD did not respond to HuffPost's inquiries as to
whether the hospital has specific rules about medical marijuana and organ transplants.
3. These ambiguous policies often appear to contradict one another. Norman Smith, a liver cancer
patient who died in 2012, was removed from the transplant list at Cedars-Sinai Medical Center in
Los Angeles after testing positive for pot. The oncologist who wrote Smith's medical marijuana
recommendation also worked at Cedars-Sinai.
"There was a total disagreement because of existing protocol," Smith said in a video uploaded to
YouTube in 2011. "There's definitively a rift in thinking between the two departments."
Smith is not the only medical marijuana user to die after being denied an organ transplant. Seattle
resident Tim Garon died in 2008 after the University of Washington Medical Center refused to put
him on the waiting list for a liver transplant, and a year later, Kimberly Reyes died at Hilo Hospital
in Hawaii for the http://california-marijuana.com same reason. While Washington has since adopted
laws protecting medical marijuana patients who need transplants, Hawaii has not.
Late last year, the California Medical Association, a coalition of physicians throughout the state,
adopted a non-binding resolution in favor of allowing marijuana patients to receive transplants. Yami
Bolanos, a cancer survivor and medical cannabis patient who has lobbied extensively in favor of
Levine's bill, said that, although the group's resolution was largely symbolic, she views it as an
important first step.
Yami Bolanos has lobbied in favor of Levine's bill.
"I hope that lawmakers will be smart and compassionate enough to know that this is a no-brainer,"
she said. "Too many people's lives are at stake."
Bolanos, who also suffers from liver cirrhosis, underwent a successful transplant 19 years ago and
started using medical marijuana to treat symptoms that cropped up during her recovery period. "For
4. four years I laid in bed, withering in pain," she said, adding that she finally allowed herself to smoke
a joint after exhausting other treatment options. "It was the first time I had any real relief in a long
time. It reminded me of when my mother would rub the bottom of my feet when I had cramps as a
child."
Levine's measure could be up for a vote in California's Assembly as early as June. Levine said he
hopes it will be signed into law by next January.
Until then, patients like Bolanos and Turley have no plans to stop using marijuana. "If my situation
ever became more dire, I would reconsider," Turley said. "But in the meantime, my quality of life is
so much better."
"I made my choice, and I won't go back to what it was like before," said Bolanos, who was told after
her first transplant that she may eventually need another one in order to survive. "I'm not going to
go out in pain. I won't go out like a whimpering dog."
Turley added that his entire life would change should the legislation pass. "Just even mentioning it
makes me feel reinvigorated," he said. "It would be like years of darkness suddenly became day."
UPDATE: In a statement emailed to HuffPost Wednesday afternoon, Jacqueline Carr, the director of
communications for UCSD Health Sciences, said that medical marijuana usage "is not an absolute
contraindication to liver transplantation at UC San Diego."
"The decision to accept or decline a patient for liver transplant listing is http://cannabis.com/ arrived
upon after a thorough assessment involving transplant hepatologists, surgeons, nurse coordinators,
social workers, and psychologists," Carr added. "Medical marijuana as prescribed by a physician in
consultation with the transplant team is never the sole reason for a patient to be
http://california-marijuana.com declined for transplant listing."
CORRECTION: An earlier version of this story misidentified the California Assembly as the California
House of Representatives.
http://www.huffingtonpost.com/2015/02/24/marijuana-organ-transplant_n_6736672.html