Hastings Center Report (vol. 47, no. 1, 2017) is available online by subscription only.
- “After the DNR: Surrogates Who Persist in Requesting Cardiopulmonary Resuscitation” by Ellen M. Robinson et al.
- “The Limits of Surrogates’ Moral Authority and Physician Professionalism: Can the Paradigm of Palliative Sedation Be Instructive?” by Jeffrey T. Berger
- “Conflating Capacity & Authority: Why We’re Asking the Wrong Question in the Adolescent Decision-Making Debate” by Erica K. Salter
- “Managing Conflicts between Physicians and Surrogates” by Carol Bayley
- “On Patient Well-being and Professional Authority” by Mildred Z. Solomon
- “A Good Death” by Tia Powell and Adira Hulkower
- “The Theory and Practice of Surrogate Decision-Making” by David Wendler
JAMA (vol. 317, no. 3, 2017) is available online by subscription only.
- “A Framework for Disseminating Clinical Best Practices in the VA Health System” by Shereef M. Elnahal, Carolyn M. Clancy, and David J. Shulkin
- “Using the Electronic Health Record to Understand and Minimize Overuse” by Juliet Rumball-Smith, Paul G. Shekelle, and David W. Bates
- “The Pediatric Research Equity Act Moves Into Adolescence” by Florence T. Bourgeois, and Thomas J. Hwang
The New England Journal of Medicine (vol. 376, no. 2, 2017) is available online by subscription only.
- “The Future of Health Care Reform — Section 1332 Waivers and State-Led Reform” by P.M. Singer
- “The 21st Century Cures Act — A View from the NIH” by K.L. Hudson and F.S. Collins
Journal of Bioethical Inquiry (vol. 13, no. 4, 2016) is available online by subscription only.
- “Regulating “Quack” Medicine and Decision-Making For Children Re-visited” by Bernadette Richards and Michaela E. Okninski
- “Relational Capacity: Broadening the Notion of Decision-Making Capacity in Paediatric Healthcare” by Katharina M. et al.
- “Participation of Children in Medical Decision-Making: Challenges and Potential Solutions” by Vida Jeremic et al.
- “Should Children Be Given Priority in Kidney Allocation?” by T. M. Wilkinson and I. D. Dittmer
- “Documentation of Capacity Assessment and Subsequent Consent in Patients Identified With Delirium” by Scott Lamont, Cameron Stewart, and Mary Chiarella
- “Inhospitable Healthcare Spaces: Why Diversity Training on LGBTQIA Issues Is Not Enough” by Megan A. Dean, Elizabeth Victor, and Laura Guidry-Grimes
- “Dialogic Consensus In Clinical Decision-Making” by Paul Walker and Terry Lovat
(UPI) – Among teens and young adults with bipolar disorder, researchers have linked brain differences to an increased suicide risk. About half of people with bipolar disorder — marked by extreme mood swings — attempt suicide and as many as one in five dies by suicide, the study authors said.
(The Atlantic) – Ana will be awake for the operation, and she’s feeling scared. As the surgeon readies his scalpel, her blood pressure is 183/93, even higher than usual. Patients undergoing procedures like this often have to be sedated to cope with the pain and anxiety of being under the knife, but not today. Instead, José Luis Mosso Vazquez, who is supervising the operation, fits a sleek, black headset over Anna’s eyes and adjusts the Velcro straps. The surgeon makes his first cut and the blood spills in a crimson stream down Ana’s leg. She’s surrounded by medical equipment—stools, trolleys, swabs, syringes, with super bright surgical lamps suspended above the bed and her vital signs displayed on monitors just behind. But Ana is oblivious.
(Wired) – The robots are coming. They’re coming to drive your car, they’re coming for your job, and they’re coming for your heart. Like, you may literally have a robotic heart one day. That is, if a peculiar new device is any indication. Researchers have developed a robotic sleeve that fits over the heart (well, a pig’s heart at the moment) and pumps like the organ would itself. The idea is that if a patient is going into cardiac arrest, the best way to help the heart is to be the heart. One day that may mean patients with cardiac problems could get their own robotic heart to kick in if their ticker starts to give way.
(Wired) – By one estimate, a quarter of all doctors in the US were not born in this country. Across the healthcare industry, from medical students to doctors to pharmacists to orderlies, lives were changed in an instant last Friday. Some, like Tourkamani, because they were separated from family. Others because they were prevented from even doing their work. According to the American of American Medical Colleges, 260 doctors from the banned nations—Iraq, Iran, Libya, Somalia, Syria, Sudan, Yemen—applied for residencies like Tourkamani’s this year. The AAMA believes these doctors may not be able to practice in the US because of the timing of the order.
(The Guardian) – Islamic scholars permit an abortion within 120 days of pregnancy in Pakistan. But despite this framework for permitting abortions, health professionals are reluctant to carry out the procedure. Many women resort to ingesting drugs, using sharp objects, or physically abusing their body resulting in long-term health complications. In 2012, an estimated 623,000 Pakistani women were treated for complications resulting from induced abortions.
(Eurekalert) – A naturally occurring hormone that plays an important role in fetal development may be the basis for a new type of reversible contraceptive that can protect ovaries from the damage caused by chemotherapy drugs. In their report receiving online publication in PNAS, a team from the Pediatric Surgical Research Laboratories in the Massachusetts General Hospital (MGH) Department of Surgery describes using Mullerian Inhibiting Substance (MIS) to halt, in a mouse model, the early development of the ovarian follicles in which oocytes mature, an accomplishment that protects these primordial follicles from chemotherapy-induced damage.
(NPR) – Prolonging life might sound like a good thing, but Warraich notes that medical technologies often force patients, their loved ones and their doctors to make difficult, painful decisions. In his new book, Modern Death, he writes about a patient with end-stage dementia who screamed “kill me” as a feeding tube was inserted into his nose. “This is probably one of the encounters that I had in residency that I have been unable to shake from my memory,” Warraich says. “I think if you ask any physician, any nurse, any paramedic, they’ll have many such stories to tell you.”
(The Scientist) – The board of directors of the American College of Medical Genetics and Genomics (ACMG) released a statement last Thursday outlining their concerns about genome editing technologies in Genetics in Medicine (January 26). “Genome editing offers great promise for the future treatment of individuals and families with genetic disorders,” the authors write, “but also raises major technological and ethical issues that must be resolved before clinical application.”
(The Atlantic) – What these kinds of DNA test start to resemble are magazine quizzes or horoscopes. At times, the science connecting DNA sequence and test result is just as shaky. And in the case of superheroes, well, it’s an explicit leap into fantasy. “Fun” was the word I kept hearing to describe these tests. We once looked to the stars to amuse, enlighten, and guide us; now we can look to DNA.
(The Australian) – Mackay-Sim has done very valuable work on the use of nasal stem cells in spinal cord injury. He was the pioneer in this country in the use of adult stem cells and proved that they were safe to use. By concentrating on the use of adult stem cells rather than embryonic stem cells, his research bypassed the most contentious ethical debates, and, what is more, he did this with very limited funds.
(PhysOrg) – CRISPR has broad implications for advances in health care and agriculture and has already been used to create genetically engineered mosquitos designed to help reduce the spread of malaria. In the wake of this major breakthrough, UVA Today asked University of Virginia public policy professor Randall Lutter to explain the impact of this new technology. Now a member of the faculty at UVA’s Frank Batten School of Leadership and Public Policy, Lutter is a former deputy commissioner for policy at the Food and Drug Administration, where he had a leadership role in efforts to regulate genetically engineered animals.
Panel Clears Dutch Doctor Who Asked Family to Hold Patient Down as She Carried Out Euthanasia Procedure
(The Telegraph) – A Dutch woman doctor who asked an elderly patient’s family to hold her down while she administered a fatal drug dose has been cleared under Holland’s euthanasia laws. Mailonline reported that the patient fought desperately in an attempt not to be killed. Jacob Kohnstamm, chairman of the Regional Review Committee, which considered the case, said: “I am convinced that the doctor acted in good faith, and we would like to see more clarity on how such cases are handled in the future.”
(USA Today) – Arkansas’ governor on Thursday approved a ban on a commonly used second-trimester abortion procedure — restrictions that are expected to face a legal challenge. Republican Gov. Asa Hutchinson signed into law a measure banning the procedure known as dilation and evacuation, which abortion-rights supporters contend is the safest and most common procedure used in second-trimester abortions. Hutchinson signed the bill hours after it was approved by the majority-GOP Senate on a 25-6 vote. It won’t take effect until later this year.
(STAT News) – Pig embryos that had been injected with human stem cells when they were only a few days old began to grow organs containing human cells, scientists reported on Thursday, an advance that promises — or threatens — to bring closer the routine production of creatures that are part human and part something else. These human-pig “chimeras” were not allowed to develop past the fetal stage, but the experiment suggests such creations could eventually be used to grow fully human organs for transplant, easing the fatal shortage of organs: 120,000 people in the United States are waiting for lifesaving transplants, but every day two dozen die before they get them.
(Pro Publica) – As the toll of the opioid epidemic grows, scores of doctors have lost their licenses and some have gone to prison. Pharmacies are being sued and shuttered. Pharmaceutical manufacturers are under investigation and face new rules from regulators. But penalties against companies that serve as middlemen between drug companies and pharmacies have been relatively scarce — until recently.
(Quartz) – The possibility of digitally interacting with someone from beyond the grave is no longer the stuff of science fiction. The technology to create convincing digital surrogates of the dead is here, and it’s rapidly evolving, with researchers predicting its mainstream viability within a decade. But what about the ethics of bereavement—and the privacy of the deceased? Speaking with a loved one evokes a powerful emotional response. The ability to do so in the wake of their death will inevitably affect the human process of grieving in ways we’re only beginning to explore.