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Full-Text Articles in Medicine and Health Sciences
"Farewell" To Prognosis In Shared Decision-Making, Robert F. Johnson
"Farewell" To Prognosis In Shared Decision-Making, Robert F. Johnson
Peer Reviewed Articles
Whether because of a cultural pattern or personal preference, palliative care clinicians encounter persons approaching the end of life who wish to limit or forego prognostic information relating to their situation. This scenario has received attention in a recent motion picture as well as a newly available advance directive modification—the Prognosis Declaration form. The ordinary expectation for end-of-life shared decision-making with a capable person is clinician disclosure of the best effort at prognostic assessment. The optimal match between the expressed values, goals, and preferences of the person with available clinician expertise is hopefully achieved. For the clinician, a person’s choice …
Implementing Palliative Care Pre-Cardiothoracic Transplant, Sarah E. Bakker
Implementing Palliative Care Pre-Cardiothoracic Transplant, Sarah E. Bakker
Honors Projects
Palliative care is defined as a specialty of medicine that improves the quality of life of patients and family members facing a life-threatening illness, by providing early detection and prevention of pain, psychological, and other physical struggles. Patients diagnosed with diseases such as congestive heart failure or lung disease will face an ongoing list of problems that impacts their quality of life, yet most do not receive the proper tools to manage their disease until the last stages of their life. Implementing palliative care at the initial diagnosis of a chronic cardiothoracic disease improves precision of patient-centered goals, symptom management, …
The Death Debate: Penumbra Conundrum, Robert F. Johnson
The Death Debate: Penumbra Conundrum, Robert F. Johnson
Peer Reviewed Articles
Determination and declaration of death by neurologic criteria, brain death, is an established and legally accepted clinical practice with profound implications. Concerns regarding the accuracy of this diagnosis raise important clinical, ethical, and legal issues. A recent magazine article highlights these concerns by describing a poignant example of a patient meeting accepted clinical and ancillary testing criteria for brain death in the setting of post cardiac arrest hypoxic ischemic encephalopathy (CA-HIE). With continuation of ventilatory and nutritional support, this patient not only survived but over time demonstrated findings that were no longer consistent with brain death. Offered here is a …
It’S Not About You—It’S About Me, Robert F. Johnson
It’S Not About You—It’S About Me, Robert F. Johnson
Peer Reviewed Articles
Hold Me, a film written and directed by Teace Snyder (2016) was distributed by email to palliative care clinicians and educators. The viewpoint presented here is not a review of this movie as a drama for entertainment. Rather it reviews the film to address the suggestion by its producers that it could serve as an adjunct to palliative care professional education.
Going Beyond ‘Do No Harm’: A Critical Annotation, Robert F. Johnson
Going Beyond ‘Do No Harm’: A Critical Annotation, Robert F. Johnson
Peer Reviewed Articles
The Op-Ed article in the New York Times (November 4th, 2016), “On Assisted Suicide, Going Beyond Do No Harm” by Haider Javed Warraich provided an articulate and timely plea for more widespread availability and application of physician-assisted dying, or “suicide”, as part of end-of-life medical care. While this profound intervention should be considered by physicians and others as an option for those able to express their wishes at the end-of-life, it must be considered in the context of the ethical principles appropriate for all health care interventions and recognized for its limited role in the overall approach to compassionate care …
Why It’S Not Ok For Doctors To Participate In Executions, Robert F. Johnson
Why It’S Not Ok For Doctors To Participate In Executions, Robert F. Johnson
Peer Reviewed Articles
A plea for direct physician participation in executions was presented by Sandeep Jauhar in a New York Times Op-Ed (“Why It’s OK for Doctors to Participate in Executions”—April 21, 2017). Jauhar’s article is not a discussion of the ethics of capital punishment. He describes his own opposition “as a matter of principle, as a doctor.” However, since capital punishment is legal in 31 states, with required physician participation in several, he acquiesces to a utilitarian stance rather than the principled approach he acknowledges is expected of a physician in this circumstance.