Medical ethics is not the typical topic of free community health discussions, but the staff at Winona Health's Senior Services, as well as staff at Home Care and Hospice in Winona, MN, have found a welcoming audience for the talk.
The overriding ethical issue of a pandemic influenza â or any other health crisis involving a contagious disease â appears to be the dilemma of balancing public health vs. individual liberties.
Depending on the ultimate decision of the Montana Supreme Court in the case of Baxter v. Montana, the complex issue of assisted suicide ultimately could mean that Montana becomes the third state in the United States to allow for physician-assisted suicide, after Oregon and more recently, Washington state.
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 So, the act is no longer in effect.
Large research institutions can improve IRB consistency, education, and networking by establishing an oversight board that will bring IRB chairs together at committee meetings.
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?
[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: jbanja@emory.edu.]
While psychiatric advance directives are not new in concept, patients tend not to take advantage of these tools.
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.
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.
