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New Challenges to Brain Death

Wednesday, February 10th, 2016

heart-beat

Since 1969, the Harvard Criteria on Brain Death have provided guidelines for declaring a patient dead, even if the heart is still beating. This has allowed for a significant expansion of organ transplants. Donation occurs while the organ is still viable, resulting in better outcomes for recipients. As a legal, ethical determinant of the end of life, brain death is enshrined as firm doctrine in all 50 states.

Two recent cases in the news, however, have called brain death into question. In Oakland, California, 13 year-old Jahi McMath suffered a catastrophic complication of an operation to treat her sleep apnea. In Forth Worth, Texas, Marlese Munoz, 14 weeks pregnant, suffered a massive pulmonary embolism. In both cases, the patient was declared brain dead. In the case of Jahi, her parents insisted that life support be maintained, in the vain hope that she might improve and survive. With Marlese, her parents wanted to have life support discontinued, but the state intervened to keep her on the ventilator because of the pregnancy.

There are separate ethical issues in the Munoz case, but one thing should be clear: neither parents nor the state should have the power to determine when a patient has died. That is a clinical determination, and brain death is well established in ethics and law. Now, it is certainly reasonable for doctors to permit families to “say goodbye” to a loved one before turning off life support, but that does not change the facts. It is not a matter for debate: both California and Texas law permit doctors to end treatments under such circumstances, even over family objections, and protect physicians against liability for doing so.

Please note: Brain death is not an assault on the sanctity of human life. Religious voices that object to brain death often assert a sort of “Christian vitalism,” that claims physical life should trump everything, perhaps even God’s sovereignty. Modern medical ethics is complicated enough without adding this confusion.

Understanding Brain Death
Controversies about Brain Death
Arthur Caplan on Brain Death

Debate over Long Hours for Surgeons in Training

Monday, January 11th, 2016

cartoon-doctor

(by guest blogger Kathryn Sill)

Most of us know that surgical trainees (residents) within hospitals can work some long shifts; 100 hour work weeks are not unusual. Recent standards by the Accreditation Council for Graduate Medical Education have attempted to reduce the number of hours to a maximum of 80 per week, in the belief that tired doctors make mistakes. But is this true?

To address the question of short versus long shifts, the Flexibility in Duty Hour Requirements for Surgical Trainees (FIRST) trial will assess residents within 117 different training programs. This study is the first of its kind to try to uncover whether the length of shifts is detrimental to the well-being of both residents and patients. Some believe that long shifts dangerously lead to fatigue among trainees. However, those opposed to shorter shifts claim that they interfere with continuity of care and hinder communication between the residents, leading to even more errors.

The results for the study will be released in February.

Sources:
Article on surgeon training study

FIRST trial information

Gene Editing in Animals May Become Controversial

Tuesday, December 1st, 2015

salmon

(by guest blogger Kathryn Sill)
Your tall glass of milk may come from an unexpected source, thanks to DNA modification in animals. Also known as gene editing, this process uses enzymes to alter an animal’s DNA in specific advantageous ways. This may change an animal’s appearance or increase muscle mass. Such methods may be used to create better food products, to fight diseases, or even to design a household pet.

There are some major ethical concerns with all of this. Animal rights activists claim it is abusive to animals, while those concerned with food safety worry about the effects of modified DNA in the food chain. Finally, many fear that gene editing in animals will eventually lead to gene editing of human embryos.

These concerns are not far-fetched. The FDA has just approved the first genetically modified salmon for widespread consumption, soon to be available in American supermarkets. Stay tuned for a complex and perhaps divisive public debate.

Sources:
* Animal Gene Editing
* Genetically Engineered Salmon

Health Care Conscience Bill Before Congress

Monday, November 23rd, 2015

health-care-md

The freedom of conscience in health care is now under attack more than ever. Nurses, doctors, and pharmacists are speaking up. From Catherina Cenzon-DeCarlo, an operating room nurse:

On May 24, 2009, the hospital where I work coerced me to assist in a 22-week abortion. My duties as a nurse included being present for the bloody dismemberment and accounting for body parts afterwards.

 

The employer threatened to fire the nurse if she did not go along with all this, despite her deeply-held religious beliefs (her beliefs had been previously identified to the hospital administration).

The modern environment in health care, based on a radical view of patient autonomy, wants to remove conscience and professionalism from medicine. If these efforts succeed, people of faith will not become healthcare providers, and the compassionate practice of medicine will erode.

S. 50, the Abortion Non-Discrimination Act, is currently before congress. It would protect any healthcare professional (doctor, nurse, physician assistant, pharmacist) or clinical entity (hospital, clinic, medical practice) from retribution or negative consequences from exercising the right to abide by their personal conscience.

Be in prayer – support your lawmakers.

Cathy’s Story (YouTube)

Freedom 2 Care Website

 

Digging Deeper: Latest PP Video Does Further Damage

Friday, October 30th, 2015

baby_in_womb

Compounding the damage of earlier revelations, an 11th video has been released by the Center for Medical Progress. The covert interview features Dr. Amna Dermish, yet another abortionist working for Planned Parenthood, this time in Texas. I recently provided comments to the online news site The Blaze. Here’s an excerpt:

The problem with the 11th video from the Center for Medical Progress, according to Sullivan, is that the dialogue presented seems to show that doctors want to provide researchers with intact calvariums, or brains. To do this, he said they would not be able to use the aforementioned method, as it would destroy the tissue that they are looking to procure.

 

“So how do they insure that the fetus dies before delivery? In the video, Dr. Dermish clearly states that she does not use digitalis to stop the heart unless the fetus is 20 weeks or older,” Sullivan said. “So I’m left with the unavoidable conclusion that some of these fetuses are born alive, then killed after birth. If true, this is a clear violation of federal law.”

 

He continued, “Nonetheless, Dr. Dermish does not explicitly admit this.”

 

Now CMP does a bit of heavy-handed editing, going back and forth with an earlier interview to make the latest revelations seem even more disturbing. Nonetheless, we should not let the Planned Parenthood doctors off the hook for their unethical behavior. And we should not use our tax dollars fund this deeply flawed organization.

Read the full article in The Blaze here.

Fighting Over Frozen Lives

Monday, September 28th, 2015

8-cell_stage_embryo

The latest chapter in the embryo wars is in California, where a couple is engaged in a bitter custody dispute over the woman’s children, currently in the form of unimplanted frozen embryos. Dr. Mimi Lee and Steven Findley underwent in vitro fertilization when Dr. Lee was diagnosed with breast cancer, making pregnancy risky. She had planned to have a genetically-related child with the help of a surrogate mother. After three years, the couple divorced. Dr. Lee, now 46, would like to have her children. Her ex-husband disagrees.

The similar 1992 Davis v. Davis embryo case in Tennessee granted embryos “special status,” but nevertheless had them destroyed. Since that time, courts have tended to consider embryos as property rather than persons. But recent rulings in Pennsylvania, Maryland, and Illinois have shown more sympathy towards women with cancer, who will not be able to have children biologically themselves. Dr. Mark Sauer, a reproductive endocrinologist, provides some clarity on the issue:

It is compelling and dramatic how these issues play out. These are embryos that will potentially live lives. It is not like you are bartering over the furniture in your house.

 

A decision in the case is likely within the next few weeks, and may set a new precedent.

News Article (LA Times)

New Journal Launch!

Tuesday, September 8th, 2015

Journal Logo framed

The Center for Bioethics is pleased to announce the launch of a new, peer-reviewed academic journal: Bioethics in Faith and Practice.

The focus of the new journal is Health Care Ethics, but it also may include articles of a more theoretical nature. Though it will emphasize Judeo-Christian values, we will be open to a large variety of voices, including secular ones. The first issue is now available online, at: http://digitalcommons.cedarville.edu/bioethics_in_faith_and_practice/.

Both academic and clinical scholars should consider submitting to the new journal. Submissions may include case study analysis or longer commentaries and reviews. Appropriate clinical ethics topics may also include reproductive ethics, end-of-life matters, stem cell research, abortion, genetic ethics, research ethics, and conscience rights for health professionals. We are open to more theoretical matters as well, such as nuances of ethical theory, meta-ethics, and metaphysics as it relates to human nature. The perspective may be from medicine, nursing, biology, pharmaceutical sciences, psychology, social work, chaplaincy, and biblical scholarship.

Articles submitted for consideration should be of interest to the educated professional, but not restricted to the specialist. An author need not be a full-time academic of a member of a college or university faculty. Submitted papers will be reviewed by the Editorial Advisory Board, made up of ten Cedarville University faculty, plus six from outside the institution.

 

 

 

Looking for Hope: Suicide Prevention

Tuesday, August 18th, 2015

Hold_my_handImage courtesy of Wikimedia Commons

by Dr. Heather Kuruvilla

Suicide is the 10th leading cause of death in the US, and is the most common cause of death after cancer and heart disease. The most recent statistics for suicide compiled by the American Foundation for Suicide Prevention show a yearly increase in the number of suicides every year since 2000.  In 2013, someone in the US died from suicide every 12.8 minutes.

Suicide is always tragic, and is also preventable.  It is estimated that over 90% of people who commit suicide were suffering from mental illness at the time of their death.  Depression is the mental illness most often correlated with suicide, though bipolar disorder and other personality disorders may also play a role.

Underdiagnosis of mental illness likely plays a key role in suicides, which means that health care professionals can help prevent this tragedy.  Treating persons holistically, recognizing the interdependence of physical and mental well-being, is of crucial importance.

As Christians, we recognize the impact that the Fall and the Curse have on all of creation.  Certainly the whole person is subject to disease, both physical and mental.  Genetic and epigenetic mutations, biochemical disorders, and anatomical dysfunctions will plague mankind until the Lord’s return.  If we wish to alleviate suffering, we need to wisely steward all of the tools at our disposal, including counseling, pharmaceuticals, and human interaction.

For too long, sufferers of mental illness have felt stigmatized, often not reaching out for needed treatments.  This needs to stop.  A holistic view of personhood can truly make a difference.

 

Planned Parenthood Issue is More than Politics

Tuesday, August 11th, 2015

Baby_feet

Even pro-choice voices get it. Chris Sununu (R), an executive councilor in New Hampshire, had previously supported services provided by Planned Parenthood in their state. That is, until they crossed the line and broke the law. Due to the intense public scrutiny over recent videos that seem to show PP execs describing how they sell fetal body parts for research, Sununu is very troubled:

Sununu laments that Democrats in his state “seem to go out of their way to ignore” the urgent questions raised by the videos released by [the Center for Medical Progress]. Governor Maggie Hassan has refused to investigate New Hampshire’s Planned Parenthood clinics based on what she calls “a rumor.” “We do not launch criminal investigations in the state of New Hampshire because somebody edits a tape,” she said.Hassan declined to help expand women’s alternatives to Planned Parenthood. That decision “made no sense,” Sununu says. “It was beyond belief. How providing choices is ever a negative thing, I can’t imagine. She’s trying to justify the monopolistic position Planned Parenthood has put themselves in.”

 

Sununu not only supported the state’s successful effort to remove $639,000 worth of Planned Parenthood funding, but he actively sought to find alternative sources to provide certain much-needed women’s health services. He defends his change of opinion with a pragmatic argument:

The councilor does not view the debate over funding Planned Parenthood as a pro-choice versus pro-life issue — the issue is whether the law is being violated, he says. “Particularly on the Republican side, it’s not political, since our politicians don’t receive campaign donations from Planned Parenthood,” he says. “The governor’s misplaced passion for the organization indicates politics.” New Hampshire’s successful move to de-fund Planned Parenthood underlines the fact that, even if Congress succeeded in cutting off federal dollars, the states would need to act to fully untangle public money from the organization. Sununu hopes New Hampshire will be an example for other states: “Change can happen at the local level.”

 

Read more

The Plot Thickens: Newest PP Video is Revealing

Tuesday, July 21st, 2015

Month 7

The Center for Medical Progress has released its second video in a three-year investigative series into the actions of Planned Parenthood (PPFA) and the marketing of fetal body parts. Secretly recorded last February, two supposed research company purchasers talk with Dr. Mary Gatter, a senior PPFA official (CMP Video).

The conversation centers mostly around pricing, and how to modify the abortion technique to produce intact organs. This is very disturbing, and confirms that the first video (featuring Dr. Deborah Nucatolo) was no fluke. This apparently is “business as usual,” with the emphasis on business.

Why this is all so upsetting:

  • The description of second and third trimester abortions is graphic, and shows abortion for what it really is: legally sanctioned dismemberment of human beings.
  • The only issue for Dr. Gatter seems to be what kind of suction to utilize to better preserve intact organs. This is a medical conflict of interest: it’s not about women’s health, but about profiting from the sale of the body parts.
  • Through it all, Dr. Gatter haggles for the best price, even joking about buying a new Lamborghini (expensive sports car). She says, “Patients don’t care what we do, of course.” This just shows the cynical and callous true nature of PPFA (see my earlier blog about the “ugly underbelly” of abortion).

No, Planned Parenthood is not “pro-women,” as they claim. It is pro-business, and anti-life.

CMP Video

Center for Medical Progress