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69One or two types of death? Attitudes of health professionals towards brain death and donation after circulatory death in three countriesMedicine, Health Care and Philosophy 16 (3): 457-467. 2013.This study examined health professionals’ (HPs) experience, beliefs and attitudes towards brain death (BD) and two types of donation after circulatory death (DCD)—controlled and uncontrolled DCD. Five hundred and eighty-seven HPs likely to be involved in the process of organ procurement were interviewed in 14 hospitals with transplant programs in France, Spain and the US. Three potential donation scenarios—BD, uncontrolled DCD and controlled DCD—were presented to study subjects during individual…Read more
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33How Can You Be Transparent About Labeling the Living as Dead?American Journal of Bioethics 17 (5): 24-25. 2017.
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26Casting Light and Doubt on Uncontrolled DCDD ProtocolsHastings Center Report 43 (1): 27-30. 2013.The ever‐increasing demand for organs led Spain, France, and other European countries to promote uncontrolled donation after circulatory determination of death (uDCDD). For the same reason, New York City has recently developed its own uDCDD protocol, which differs from European programs in some key ways. The New York protocol incorporates a series of technical and management improvements that address some practical problems identified in response to European uDCDD protocols. However, the more fu…Read more
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5Physicians’ Quantitative Assessments of Medical FutilityJournal of Clinical Ethics 5 (2): 100-105. 1994.
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72Quality Attestation for Clinical Ethics Consultants: A Two‐Step Model from the American Society for Bioethics and HumanitiesHastings Center Report 43 (5): 26-36. 2013.Clinical ethics consultation is largely outside the scope of regulation and oversight, despite its importance. For decades, the bioethics community has been unable to reach a consensus on whether there should be accountability in this work, as there is for other clinical activities that influence the care of patients. The American Society for Bioethics and Humanities, the primary society of bioethicists and scholars in the medical humanities and the organizational home for individuals who perfor…Read more
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1The Oxford Handbook of Ethics at the End of Life (edited book)Oxford University Press. 2014.This handbook explores the topic of death and dying from the late twentieth to the early twenty-first centuries, with particular emphasis on the United States. In this period, technology has radically changed medical practices and the way we die as structures of power have been reshaped by the rights claims of African Americans, women, gays, students, and, most relevant here, patients. Respecting patients’ values has been recognized as the essential moral component of clinical decision making. T…Read more
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359Should individuals choose their definition of death?Journal of Medical Ethics 34 (9): 688-689. 2008.Alireza Bagheri supports a policy on organ procurement where individuals could choose their own definition of death between two or more socially accepted alternatives. First, we claim that such a policy, without any criterion to distinguish accepted from acceptable definitions, easily leads to the slippery slope that Bagheri tries to avoid. Second, we suggest that a public discussion about the circumstances under which the dead donor rule could be violated is more productive of social trust than…Read more
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34Poverty: Not a Justification for Banning Physician‐Assisted DeathHastings Center Report 48 (6): 38-46. 2018.Many critics of the legalization of physician‐assisted death oppose it in part because they fear it will further disadvantage those who are already economically disadvantaged. This argument points to a serious problem of how economic considerations can influence medical decisions, but in the context of PAD, the concern is not borne out. We will provide empirical evidence suggesting that concerns about money influence medical decisions throughout the full course of illness, but at the end of life…Read more
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38When slippery slope arguments miss the mark: a lesson from one against physician-assisted deathJournal of Medical Ethics 44 (10): 657-660. 2018.In 1989, Susan Wolf convincingly warned of a troublesome consequence that should discourage any movement in American society towards physician-assisted death—a legal backlash against the gains made for limiting life-sustaining treatment. The authors demonstrate that this dire consequence did not come to pass. As physician-assisted suicide gains a foothold in USA and elsewhere, many other slippery slope arguments are being put forward. Although many of these speculations should be taken seriously…Read more
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27When Is "Dead"?Hastings Center Report 29 (6): 14. 1999.One way of increasing the supply of vital organs without violating the dead donor rule is to declare death on cardiopulmonary criteria after withdrawing life support. The question then is how quickly death may be declared.
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32Talking about death is not the same as communicating about deathJournal of Medical Ethics 41 (4): 303-303. 2015.
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21“Allow natural death” is not equivalent to “do not resuscitate”: a responseJournal of Medical Ethics 34 (12): 887-888. 2008.
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Character and ethics consultation: Even the ethicists don't agreeIn Mark P. Aulisio, Robert M. Arnold & Stuart J. Youngner (eds.), Ethics Consultation: From Theory to Practice, Johns Hopkins University Press. 2003.
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26Physicians' quantitative assessments of medical futilityJournal of Clinical Ethics 5 (2): 100. 1994.
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36Thoughts of Hastening Death among Hospice PatientsJournal of Clinical Ethics 11 (1): 56-65. 2000.
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20A Model System Works: Looking Deeper than SuicideJournal of Clinical Ethics 4 (4): 332-333. 1993.
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51"Allow natural death" is not equivalent to "do not resuscitate": a responseJournal of Medical Ethics 34 (12): 887-888. 2008.Venneman and colleagues argue that “do not resuscitate” (DNR) is problematic and should be replaced by “allow natural death” (AND). Their argument is flawed. First, while end-of-life discussions should be as positive as possible, they cannot and should not sidestep painful but necessary confrontations with morality. Second, while DNR can indeed be nonspecific and confusing, AND merely replaces one problematic term with another. Finally, the study’s results are not generalisable to the population…Read more
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42Resolving problems at the intensive care unit/oncology unit interfacePerspectives in Biology and Medicine 31 (2): 299. 1988.
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12The Psychological and Moral Consequences of Participating in Human Fetal-Tissue ResearchJournal of Clinical Ethics 4 (4): 356-358. 1993.
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86Propranolol and the prevention of post-traumatic stress disorder: Is it wrong to erase the “sting” of bad memories?American Journal of Bioethics 7 (9). 2007.The National Institute of Mental Health (Bethesda, MD) reports that approximately 5.2 million Americans experience post-traumatic stress disorder (PTSD) each year. PTSD can be severely debilitating and diminish quality of life for patients and those who care for them. Studies have indicated that propranolol, a beta-blocker, reduces consolidation of emotional memory. When administered immediately after a psychic trauma, it is efficacious as a prophylactic for PTSD. Use of such memory-altering dru…Read more
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91Philosophical debates about the definition of death: Who cares?Journal of Medicine and Philosophy 26 (5). 2001.Since the Harvard Committees bold and highly successful attempt to redefine death in 1968 (Harvard Ad Hoc committee, 1968), multiple controversies have arisen. Stimulated by several factors, including the inherent conceptual weakness of the Harvard Committees proposal, accumulated clinical experience, and the incessant push to expand the pool of potential organ donors, the lively debate about the definition of death has, for the most part, been confined to a relatively small group of academics w…Read more
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70For Experts Only? Access to Hospital Ethics CommitteesHastings Center Report 21 (5): 17-24. 1991.How closely involved with hospital ethics committees should patients and their families become? Should they routinely have access to committees, or be empowered to initiate consultations? To what extent should they be informed of the content or outcome of committee deliberations? Seeing ethics committees as the locus of competing responsibilities allows us to respond to the questions posed by a patient rights model and to acknowledge more fully the complex moral dynamics of clinical medicine.
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12Do‐Not‐Resuscitate Orders: No Longer Secret But Still a ProblemHastings Center Report 17 (1): 24-33. 1987.Over the past decade, public discussion has focused on the ethics of issuing Do‐Not‐Resuscitate Orders, and the failure of many hospitals to acknowledge their actions openly. Recent efforts on the part of some hospitals to establish formal DNR guidelines that are prudent, fair, and humane, are a helpful beginning, though they cannot account for all the vagaries of illness and human communication. But concerns about DNR should not divert us from looking closely and rigorously at other, more commo…Read more
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84Death and organ procurement: Public beliefs and attitudesKennedy Institute of Ethics Journal 14 (3): 217-234. 2004.: Although "brain death" and the dead donor rule—i.e., patients must not be killed by organ retrieval—have been clinically and legally accepted in the U.S. as prerequisites to organ removal, there is little data about public attitudes and beliefs concerning these matters. To examine the public attitudes and beliefs about the determination of death and its relationship to organ transplantation, 1351 Ohio residents ≥18 years were randomly selected and surveyed using random digit dialing (RDD) samp…Read more
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16The Authors ReplyHastings Center Report 45 (6): 4-5. 2015.A response to “CAHPS Surveys: Valid and Valuable Measures of Patient Experience,” byWilliam G. Lehrman and Mark W. Friedberg, and to “Courage, Context, and Contemporary Health Care,” by Jeffrey T. Berger
Cleveland, Ohio, United States of America