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:3/24/2017)... ... March 24, 2017 , ... ... Walk with God #TruthwithGrace”: a devotional journal chronicling the writer’s path toward true ... How to Walk with God #TruthwithGrace” is the creation of published author Lea ...
(Date:3/24/2017)... ... March 24, 2017 , ... “The Communion ... real people of God in congregations across the United States. “The Communion ... ordained in 1964 who has served congregations in seven states throughout his long ...
(Date:3/23/2017)... Boulder, CO (PRWEB) , ... March 23, 2017 , ... ... higher bar for entry into teacher preparation programs. The NCTQ report suggests, based on ... boosting entry requirements would significantly improve teacher quality in the U.S. It argues that ...
(Date:3/23/2017)... New Braunfels, TX (PRWEB) , ... March 23, 2017 , ... ... a new clinic, located at 960 Gruene Road in Building 2. The clinic is ... co-owner Dr. Andrew Bennett, PT, says opening the company’s second New Braunfels location brings ...
(Date:3/23/2017)... Holland, PA and Grimsby, Ontario (PRWEB) , ... March 23, 2017 , ... The MBI ... the modular industry or whose acts have had a significant impact on the careers of ... Sales and Marketing with NRB Inc. was inducted into the MBI’s Hall of Fame. ...
Breaking Medicine News(10 mins):
(Date:3/24/2017)... 2017  Mirabilis Medical, a Seattle ... non-invasive surgery, announced today CE Mark authorization for ... uterine fibroids throughout the European Union.  The company ... the US Food and Drug Administration to begin ... the United States.  The Mirabilis System combines high-speed ...
(Date:3/24/2017)... and GENEVA , March 24, 2017 ... Tuberculosis Day revitalizes efforts to develop sutezolid as effective ... World Tuberculosis Day, TB Alliance and the Medicines Patent ... development of sutezolid, an antibiotic drug candidate which demonstrated ... the development of sutezolid in combination with other TB ...
(Date:3/23/2017)... , Mar 23, 2017 Research and Markets ... & Trends - Industry Forecast to 2025" report to their ... The ... around 6.9% over the next decade to reach approximately $3.5 billion ... and forecasts for all the given segments on global as well ...
Breaking Medicine Technology: