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:10/13/2017)... ... ... Apple Rehab Shelton Lakes , which specializes in the delivery of sub-acute ... of a disaster drill on October 3rd. , Apple Rehab participated with the Shelton ... well as the Connecticut Long Term Care Mutual Aid Plan (LTC-MAP). The LTC-MAP ...
(Date:10/13/2017)... ... October 13, 2017 , ... The Visiting Nurse Association (VNA) ... a collection of specialty vendors and unique items from across the nation, this holiday-themed ... and wellness services offered by the VNA. The boutique will be open Saturday, ...
(Date:10/13/2017)... ... October 13, 2017 , ... Global Healthcare Management’s 4th Annual Kids ... Milford, NJ. This free event, sponsored by Global Healthcare Management’s CEO, Jon Letko, ... run is geared towards children of all ages; it is a non-competitive, non-timed event, ...
(Date:10/13/2017)... ... 13, 2017 , ... Talented host, actor Rob Lowe, is ... a new episode of "Success Files," which is an award-winning educational program broadcasted ... each subject in-depth with passion and integrity. , Sciatica occurs when the sciatic ...
(Date:10/13/2017)... ... October 13, 2017 , ... “The Journey: From the ... danger possible to save lost souls in the Philippines. “The Journey: From the Mountains ... a dedicated teacher of the Bible. She has taught all ages and currently teaches ...
Breaking Medicine News(10 mins):
(Date:10/11/2017)... , Oct. 11, 2017  BioPharmX Corporation (NYSE ... team that developed an innovative way to use nonlinear ... the delivery of new drugs. ... Clinical Dermatology Conference will show how researchers from BioPharmX ... Harvard Medical School used a suite of imaging techniques ...
(Date:10/10/2017)... --  West Pharmaceutical Services, Inc. (NYSE: WST), a ... today shared the results of a study highlighting the ... administration of polio vaccines. The study results were presented ... by Dr. Ondrej Mach , Clinical Trials and ... and recently published in the journal Vaccine. i ...
(Date:10/4/2017)... LAWRENCE, Mass. , Oct. 4, 2017 /PRNewswire/ ... developer of single-use, self-contained, illuminating medical devices, today ... National Health Surveillance Agency (or Agência Nacional ... ®. The first single-use, cordless surgical retractor with ... ONETRAC provides optimal access, illumination and exposure of ...
Breaking Medicine Technology: