Managing Your Practice, Bioethics

Approaching Ventilator Withdrawal

Posted June 30th, 2009 in Health Policy, Managing Your Practice

The decision to extubate a patient who is ventilator-dependent is usually difficult. Problems may arise in communication with the patient and/or family, issues of differences in beliefs and culture with regard to life-sustaining treatment, certainty of prognosis, practical issues of location (in the ICU, on a med-surg floor, at home, or referral to a hospice inpatient care center) and care delivery. The following case illustrates some of these.

Topics: Bioethics, Bioethics Commission, End-of-life Care, SDCMS News and Updates, ventilator withdrawal

Challenging Symptoms? Expert Advice.

Posted June 30th, 2009 in Health Policy, Managing Your Practice

“In California, 75 percent of adults over 65 have at least one chronic condition that requires ongoing care. And in just three years, the nation’s 78 million Baby Boomers will begin turning 65.” (The Institute of Medicine of the National Academies, May 2008)

Topics: Bioethics, palliative medicine resource hotline, San Diego Hospice, SDCMS News and Updates

Model Hospital Policy on Non-beneficial Treatment and Conflict Resolution

Posted June 30th, 2009 in Health Policy, Managing Your Practice

[Click here to download this form in Word or in PDF.]

I. Abstract

Frequently, conflicts arise when parties disagree on the best course of action in the care of a patient. If the treating team believes that:

Topics: Bioethics, Bioethics Commission, conflict resolution, hospital policy, medical ethics, non-beneficial treatment, SDCMS News and Updates

With Liberty and Justice for All

Posted June 30th, 2009 in Health Policy, Managing Your Practice

Note: May I acknowledge my belief (and bias), based on my life experience, that a single-payer system would best serve the nation.

Liberty and justice. Let us look at each of these two core values of the American experience in light of the current access to healthcare crisis.

Topics: Bioethics, ethics, healthcare reform, justice, liberty, mandates, medical ethics, single payer

A 68-year-old Man Is Hospitalized With Acute Stroke

Posted October 8th, 2008 in Health Policy, Managing Your Practice

Ethics Case: 68-year-old man is hospitalized with acute stroke after collapsing on the golf course. Upon admission, patient was treated with TPA. His stroke subsequently became hemorrhagic, requiring emergent craniotomy. The patient never regained consciousness. After two weeks, his wife consented for tracheostomy and gastrostomy tube insertion. One month after admission, he remains unresponsive. He has non-purposeful movements of his left side. He does not follow commands. His pupils are equal but unresponsive to light.

Topics: Bioethics, End-of-life Care, medical futility

Whether or Not to Engage in Further Treatment

Posted October 6th, 2008 in Health Policy, Managing Your Practice

Reason for Bioethics Consultation

Topics: Bioethics, medical futility

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