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Banja: Here's a direction in the brain death debate that I think is most interesting: The Religious Freedom Restoration Act. Now, this act was passed in 1993 but in 1997 it was declared unconstitutional by the U.S. Supreme Court. So, the act is no longer in effect.
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Large research institutions can improve IRB consistency, education, and networking by establishing an oversight board that will bring IRB chairs together at committee meetings.
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Are the medications safely out of reach of children? Can the family caregiver handle tasks required to care for the patient? Are family members following the wishes of the patient as indicated before he or she developed dementia? Is the patient safe in the home setting? Is the employee safe in the patient's home?
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[Editor's note: Dr. Banja is a Professor in the Department of Rehabilitation Medicine; a Medical Ethicist at the Center for Ethics; and the Director of the Section on Ethics in Research at Emory University in Atlanta. E-mail:
[email protected].]
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While psychiatric advance directives are not new in concept, patients tend not to take advantage of these tools.
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A study published in the March 9, 2009, issue of Archives of Internal Medicine, which revealed that patients with advanced cancer who reported talking to their physicians about their end-of-life care wishes had significantly lower health care costs in the last week of life.
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Feelings of abandonment on the part of patients and their caregivers are not uncommon as they transition from treatment to end-of-life care, according to a recent study completed by a team at the University of Washington.
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Boutique; concierge; retainer. These are all words used to describe physician practices that charge patients an annual fee for access. And while there don't appear to be firm numbers on such practices, some say they are meeting an important need in a broken health care system.
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[Editor's note: This is Part 2 of an article that appeared in the April 1, 2009, issue of Medical Ethics Advisor.]
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For the past decade, patient safety and quality care and all the assistant care policies and standards associated with quality initiatives have been directed at improving efficiencies of both cost and process within health care institutions.
