Tag: death

Bioethics Blogs

Politics of Pain: Investigating the Ethics of Palliative Care as a Global Human Right

by Alix Masters

Within the last decade, strides have been made in the field of global health policy to extend the reaches of palliative care universally.  In 2014, the World Health Organization formally declared palliative care a global human right.[1] This development in global health policy is a positive one when we consider the medical politics of pain relief across racial difference.  Both in the United States and abroad, there is a long medical history of discriminatory practices against certain groups of people with regard to pain management—including withholding necessary pain medication altogether.  Therefore, in many ways the declaration of palliative care as a human right is a necessary step in ensuring all peoples, regardless of identity, have their pain taken seriously by the medical establishment and have their comfort made a medical priority.  When we consider how different cultures negotiate beliefs around death and pain relief, however, the issue of palliative care as a universal human right becomes more complex.  For example, countries with strong histories of Buddhist thought and culture have traditionally opposed the ideology of palliative care.[26]  In Buddhism, suffering is considered an inextricable part of life and masking this suffering through medical intervention is looked down upon.[2]  For example, Vietnam, a country with a culture strongly imbued with Eastern Buddhist values, has a long history of rejecting palliative care and pain medications in general.[26]  Due to this, the World Health Organization’ declaration that palliative care is a universal human right could also be understood as a Western organization blatantly ignoring Buddhist cultural traditions.  While the declaration of palliative care as a human right is important progress in many ways, it is also important that Western medicine not impose our values globally without consideration for the complex histories and belief systems of diverse cultures.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics Blogs

Israel Stinson Brain Death Lawsuit Continues

Judge Mueller

This week, the Alameda County Superior Court denied the defendants’ motion for summary adjudication in the Jahi McMath case.


Meanwhile, over in Sacramento, the U.S. District Court for the Eastern District of California heard oral arguments on those defendants’ motion to dismiss the action brought by the family of Israel Stinson against the State of California. 


Attorneys, Kevin Snider, Matthew McReynolds, and Alexandra Snyder appeared for the plaintiff. Attorney, Ashante Norton appeared for defendant Karen Smith.The court took the matter under submission with a formal written order to issue. 

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics Blogs

Beauty’s Knowledge: Hawthorne’s Moral Fable “Rappaccini’s Daughter” by Leo Coleman

Nathaniel Hawthorne’s story “Rappaccini’s Daughter” is a nineteenth-century moral fable that sets the fruits of experimental knowledge against obligations to humanity, and stages a dramatic encounter between these two apparent goods. In many ways, the moral it offers seems familiar, and could be recognized by anyone with even a passing familiarity with contemporary bioethical debates. It features a mad scientist’s garden, a gorgeous but poisonous plant of his creation, and a lovely daughter who tends to his terrible plants, and who is—like the plant—both attractive and potentially infectious. The daughter receives the attentions of a naïve medical student, and she falls in love with him, but their fate is shadowed by the actions of not one but two bad scientist father-figures who experiment upon the younger characters and try to shape their (biological) destinies without their knowledge. But Hawthorne’s story does not simply anticipate, in an antique and allegorical way, contemporary defenses of human dignity and nature’s inviolability. Nor does it merely rehearse, with its private garden and unknowingly experimented-upon subjects, a Lockean notion of our own inevitable and natural possession of our bodies and the fruits of our lives and labor.

Hawthorne’s story puts the experimental subject at the center of its moral allegory, suffering both hopes and fears provoked by her own mutability, her own biological plasticity. That is, his titular character is no innocent pawn in the hands of the great scientist: she is an artificial being—grafted and forced—and deeply morally and biologically transformed from the very beginning; but because of this she is also able to reflect on her relations with others and her environment, and to mark (in this case, tragically) a new ethical frontier.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics News

Judge Opens Door for Lawsuit Over Girl Declared Brain Dead

September 8, 2017

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Alameda County Judge Stephen Pulido ruled Tuesday that it’s up to a jury to determine whether Jahi McMath is alive, which would increase the damages jurors could award if they determine doctors at Children’s Hospital in Oakland botched a routine operation to remove the girl’s tonsils.

In California, non-economic damages such as pain and suffering are capped at $250,000 for medical malpractice. But juries can award unlimited economic damages far above that cap for ongoing medical care, which Jahi’s family could not claim if she were declared dead.

Jahi’s case has been at the center of national debate over brain death since the girl’s mother refused to remove her daughter from life support after doctors declared the then-13-year-old dead after surgery in December 2013.

… Read More

Image: By Blcksx – I took this photograph while visiting Riverside, CC BY-SA 3.0, https://en.wikipedia.org/w/index.php?curid=44291738

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The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics Blogs

American Nurses Association Supports VSED

Too few medical associations have issued either practice guidelines or policies on VSED. Fortunately, the American Nurses Association issued a favorable position statement this summer. 


The ANA concludes: “VSED at the end of life is used to hasten death, and is a reflection of autonomy and the patient’s desire for control.”

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics News

Why Can’t More American Women Access Medications for Preterm Birth?

September 7, 2017

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In 2015, for the first time in eight years, the rate of preterm birth in the U.S. rose, despite increased understanding of preventative measures. By one estimate, preterm births cost us an estimated $26 billion per year.

Additionally, U.S. maternal death rates are the among the worst for economically similar countries, currently double that of Canada and Spain, and almost three times than for women in Japan. In Texas, they doubled in just over two years.

When the rates are examined more closely, they reveal an alarming narrative about differences in health outcomes that are systematic, avoidable and unjust. The increased burden of preterm birth on low-income, urban and black women in America is 48 percent higher that of white women in every state.

… Read More

Image: By Mattopaedia – Own work by uploader – modified version of Stethoscope-2.png wikimedia image, Public Domain, https://commons.wikimedia.org/w/index.php?curid=6079126

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The Conversation US

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The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics Blogs

Jahi McMath Case Now Headed to a Jury Trial on Whether She Is Now Alive

Alan Shewmon  allowed to testify

Earlier this year, the medical defendants in Jahi McMath’s medical malpractice lawsuit filed a motion
to dismiss her claims. They argued that McMath lacks standing to sue for
personal injuries because she was pronounced dead in December 2013.

Yesterday, the Alameda County Superior Court denied those motions for
summary adjudication. “[T]hough Defendants have shown that the
determination of brain death in December 2013 was made in accordance with
accepted medical standards . . . a triable issue of fact exists as to whether
McMath currently satisfies the statutory definition of ‘dead’ under the Uniform
Determination of Death Act.”

“[D]espite the fact that Dr. Shewmon has not performed a formal determination of brain death as addressed in the Guidelines, Defendants have not cited authority that his opinions are of no weight or admissibility in addressing the changed circumstances alleged in the First Cause of Action.”

“[W]hile the Guidelines are generally accepted medically, there is some discrepancy between what the Guidelines diagnose and what the statutory definition of death specifies . . .  In re Guardianship of Hailu (Nev. 2015) . . .”

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics Blogs

‘Being a burden’: a illegitimate ground for assisted dying

The issue of the legality in England and Wales of physician-assisted suicide has recently been revisited by the Court of Appeal. Judgment is awaited. The judgment of the Court of Appeal, granting permission for judicial review, is here.

The basic issue before the Court of Appeal was the same as that in Nicklinson v Ministry of Justice and R (Purdy) v DPP: does the right to determine how one lives ones private life (protected by Article 8 of the European Convention on Human Rights)  confer a right to have an assisted death?

Many factors have been said to be relevant to decisions about assisted dying. They include are intractable pain (rather a weak criterion, given modern palliative methods), hopeless prognosis – likely to result in death in a short time, and simple autonomy (‘It’s my right to determine where, when, and in what circumstances I end my life, and that’s an end of the matter’). One factor, commonly in the minds of patients asking for help in ending their lives, but rarely mentioned by advocates of assisted dying, is that the patient feels that she is a burden to her family and carers.

A recent systematic review of the literature concluded that 19-65% of terminally ill patients felt that they were a burden to others.  The 2016 Report relating to the Oregon Death with Dignity Act  concluded that 48.9% of patients whose lives were ended under the Act cited seeking an assisted death cited ‘being a burden’ as one of their concerns.

Concern about being a burden should not be a criterion to which any law relating to assisted dying should be permitted to have regard.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics News

Transhumanism. Error of the gods and the power of man? A phylosofical approach

Technological progress urgently needs the emergence of moral progress so that the spark of reason does not consume the existence of humankind

The technical skills of humans have always been remarkable throughout history, so much so that, even now, the artifacts of classical antiquity leave us astounded at the ingenuity of man. Those who are familiar with the Antikythera mechanism (see video HERE) can attest to the fact that the complexity of this computing system, devised to calculate the movement of the stars, is staggering. The wonder that our creations elicit in us might make us think that the creative and technical ability that characterizes us has a divine origin.

It was Plato, among others, who described in his Protagoras, and put into the mouth of the famous Athenian sophist, the myth of the formation of man. In it, the gods forge the mortal races from other gods that have not yet finished forming in the elements of earth and fire. Thus, the gods command the brothers Prometheus and Epimetheus to capture these incomplete gods and divide their abilities to distribute them among the mortal races. Hence, the link of the mortal races with the gods is obvious according to the myth, because they are formed from the fragments of incomplete gods.

Epimetheus asks Prometheus to allow him to take charge of the formation of the new races, and distributes the fragmented abilities. His intention is to create a balance between the new beings so that they do not destroy each other. Those that enjoy some advantage over the rest are surpassed by others in another aspect.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics Blogs

Pray Tell, What Does Harvey have to do with Abortion?

Nothing brings out the true color of people as clearly as a national catastrophe such as hurricane Harvey. “Beautiful” has been the color of the vast majority of people who have been victims of, or responders to, one of the worst natural disasters in U.S. history. Many people who watched their houses and possessions float away, who must have wondered how they will ever recover from their losses, nevertheless are painting the beautiful colors of faith, trust, courage, and patience. Many people who have put their own jobs and lives on hold to go down to Houston to help strangers in need, to pluck them out of the flood waters, to feed and shelter them, and to give them the proverbial shirt off their backs, are painting the beautiful colors of love, service, and sacrifice toward fellow human beings in need. Yes, Harvey has brought out many beautiful colors, as the vast majority of people have displayed the best of what human beings are capable of.

However, tragedies also bring out the true “ugly” colors of other people. Looters have broken into business and private dwellings and have wantonly stolen what did not belong to them. On some occasions, first responders have been robbed and even shot at. And when the flood waters recede and flood victims begin to rebuild their homes and lives, be assured that scammers will make the rounds, taking advantage of people in great need to pad their own greedy pockets with ill-gotten gain. Yes, Harvey has brought out many ugly colors, as a few people have displayed the worst of what human beings are capable of.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.