Navigation Links
Reasoning through the rationing of end-of-life care
Date:1/19/2010

Acknowledging that the idea of rationing health care, particularly at the end of life, may incite too much vitriol to get much rational consideration, a Johns Hopkins emeritus professor of neurology called for the start of a discussion anyway, with an opinion piece featured in this month's issue of the Journal of Medical Ethics.

In the January article, John Freeman, M.D., Lederer Professor Emeritus of Pediatric Neurology and a faculty member of the Johns Hopkins Berman Institute of Bioethics, asks the Obama administration to consider rationing end-of-life care as an initial step towards healthcare reform.

The piece, "Rights, Respect For Dignity And End-Of-Life Care: Time For A Change In The Concept Of Informed Consent," starts with the premise that futile and expensive care at the end of life is widespread, that it has been a major contributor to the increasingly unaffordable cost of healthcare and that the nation is unable to provide it equitably to all.

He goes on to say that while administering such careas ordered through a living will, next of kin or parentshould be respected, he advocates that the ethical imperatives of "patient autonomy" and "surrogate autonomy" (passing responsibility for decision-making to next of kin when a patient no longer is competent to make his own decisions) should be weighed against the societal impact and costs of such care in futile circumstances.

"Perhaps when surrogate autonomy and the ethical principles of beneficence"the duty to do more good than harm"compete with the utilitarian principle of doing the greatest good for society, the family be given a 'nudge' towards comfort care only," Freeman suggests in the piece.

"There must be few situations more undignified, more dehumanizing or more humiliating than lying in bed, incontinent, tube fed, with or without a respirator, unable to speak or to relate to individuals or the environment," Freeman says, factors that more surrogates may want to give more weight.

Rationing and providing only comfort care should be considered not just at the end of life for adults, Freeman maintains, but also in instances of extremely premature births. He cites studies showing that intensive care for infants born at 22-23 weeks resulted in more than 1,700 extra days in intensive care, with less than 20 percent surviving. Of those 20 percent, less than 3 percent survived without profound impairment that required expensive interventions.


'/>"/>

Contact: Michael Pena
mpena@jhsph.edu
410-625-7872
Johns Hopkins Medical Institutions
Source:Eurekalert

Related medicine news :

1. Choirs To Raise Voices, Stroke Awareness Through Most Powerful Voices Competition
2. Haiti: Lifesaving Aid Makes Its Way Through to Quake-Hit Jacmel by Ship
3. Medical Breakthrough: Drug Free Strategy Shows Promise for Reversing or Halting Osteoporosis for Michigan Men and Women
4. American Humane Association Supports Animal Relief Efforts in Haiti Through International Coalition
5. Genetix Pharmaceuticals' Adrenoleukodystrophy (ALD) Product Recognized As One of Science Magazine's Top 10 Scientific Breakthroughs of 2009
6. Biggest Medical Breakthroughs and Milestones of the Last Decade Broadcast on SIRIUS XMs Doctor Radio Channel
7. Texas A&M prof working on new ways to see through the human body
8. Breakthrough Treatment for Diabetic Neuropathy Introduced
9. Now Millions Suffering With Alcohol Addiction Can Get Breakthrough Recovery in Ultimate Privacy
10. American Ambulance Association Introduces First National Emergency Health Registry Through invisibleBracelet.org
11. BCBSNC Rewarding Physicians for Better Care, Not More Care, Through Blue Quality Physician Program
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:4/25/2017)... , ... April 25, 2017 , ... A stressful work ... work can also decrease overall productivity and performance in the workplace. The goal of ... During the last few weeks of April, Clearview Resolution Services will be shutting down ...
(Date:4/25/2017)... ... April 25, 2017 , ... ... modern procedure that achieves results in a fraction of the time as traditional ... NV, with Significance Dental Specialists, now offers this revolutionary treatment with or without ...
(Date:4/25/2017)... ... , ... Saad B. Chaudhary, MD is committed to providing the highest quality of spine care ... on preventative care with all my patients to alleviate possible future issues. I am pleased ... contact my office and my trained staff will assist you in any way possible.” , ...
(Date:4/25/2017)... ... April 25, 2017 , ... Amendia, Inc., ... of its strategic partnership with and platinum sponsorship of Global Spine Outreach (“GSO”), ... and effective management of complex spine deformity cases, particularly in children. , GSO’s ...
(Date:4/24/2017)... Lake City, UT (PRWEB) , ... April 24, 2017 , ... ... their efforts to encourage sustainability, innovate new strategies to reduce waste, and support renewable ... herbal remedy provider. They look to nature to find solutions for health issues, and ...
Breaking Medicine News(10 mins):
(Date:4/20/2017)... Research and Markets has announced the addition ... Addressing Production Complexities Through Risk Management and Quality by ... ... Market Prospects: Overcoming Production Complexities Through Risk Management and ... current trends in the global biosimilars market, with a ...
(Date:4/20/2017)... , April 20, 2017  AbbVie (NYSE: ABBV), ... percent (n=145/146) of chronic hepatitis C virus (HCV) ... or 6 and compensated cirrhosis (Child-Pugh A) achieved ... 12 ) with its investigational, pan-genotypic regimen of ... were seen following 12 weeks of G/P treatment ...
(Date:4/19/2017)... CRH) (NYSE MKT: CRHM) (the "Company"), announces that it will participate ... the Sheraton Hotel in Toronto, Ontario . ... is scheduled to present on Tuesday, May 2 at 10:00 am. ... the Board, Tony Holler will also attend the event. ... For more details about the ...
Breaking Medicine Technology: