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  1. A Good Death.Tia Powell & Adira Hulkower - 2017 - Hastings Center Report 47 (1):28-29.
    A good death is hard to find. Family members tell us that loved ones die in the wrong place—the hospital—and do not receive high-quality care at the end of life. This issue of the Hastings Center Report offers two articles from authors who strive to provide good end-of-life care and to prevent needless suffering. We agree with their goals, but we have substantial reservations about the approaches they recommend. Respect for the decisions of patients and their surrogates is a relatively (...)
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  • The Theory and Practice of Surrogate Decision‐Making.David Wendler - 2017 - Hastings Center Report 47 (1):29-31.
    When a patient lacks decision-making capacity and has not left a clear advance directive, there is now widespread agreement that patient-designated and next-of-kin surrogates should implement substituted judgment within a process of shared decision-making. Specifically, after discussing the “best scientific evidence available, as well as the patient's values, goals, and preferences” with the patient's clinicians, the patient-designated or next-of-kin surrogate should attempt to determine what decision the patient would have made in the circumstances. To the extent that this approach works, (...)
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  • Characteristics and Outcomes of Ethics Consultations on a Comprehensive Cancer Center’s Gastrointestinal Medical Oncology Service.Virginia Corbett, Andrew S. Epstein & Mary S. McCabe - 2018 - HEC Forum 30 (4):379-387.
    The goal of this paper is to review and describe the characteristics and outcomes of ethics consultations on a gastrointestinal oncology service and to identify areas for systems improvement and staff education. This is a retrospective case series derived from a prospectively-maintained database of the ethics consultation service at Memorial Sloan Kettering Cancer Center. The study analyzed all ethics consultations requested for patients on the gastrointestinal medical oncology service from September 2007 to January 2016. A total of 64 patients were (...)
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  • Managing Conflicts Between Physicians and Surrogates.Carol Bayley - 2017 - Hastings Center Report 47 (1):24-26.
    Two articles in this issue of the Hastings Center Report explore two sides of the same problematic coin. In “The Limits of Surrogates’ Moral Authority and Physician Professionalism,” Jeffrey Berger discusses the moral problem of a surrogate refusing a treatment, palliative sedation, on behalf of a patient whose suffering is refractory to intensive palliative efforts provided by a multidisciplinary team. In “After the DNR: Surrogates Who Persist in Requesting Cardiopulmonary Resuscitation,” Ellen Robinson and her colleagues analyze data from a study (...)
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  • On Patient Well‐Being and Professional Authority.Mildred Z. Solomon - 2017 - Hastings Center Report 47 (1):26-27.
    Two papers in this issue address the limits of surrogates’ authority when making life-and-death decisions for dying family members or friends. Using palliative sedation as an example, Jeffrey Berger offers a conceptual argument for bounding surrogate authority. Since freedom from pain is an essential interest, when imminently dying, cognitively incapacitated patients are in duress and their symptoms are not manageable in any other way, clinicians should be free to offer palliative sedation without surrogate consent, although assent should be sought and (...)
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  • Approaches to Parental Demand for Non-Established Medical Treatment: Reflections on the Charlie Gard Case.John J. Paris, Brian M. Cummings, Michael P. Moreland & Jason N. Batten - 2018 - Journal of Medical Ethics 44 (7):443-447.
    The opinion of Mr. Justice Francis of the English High Court which denied the parents of Charlie Gard, who had been born with an extremely rare mutation of a genetic disease, the right to take their child to the United States for a proposed experimental treatment occasioned world wide attention including that of the Pope, President Trump, and the US Congress. The case raise anew a debate as old as the foundation of Western medicine on who should decide and on (...)
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