Someone old enough to be a consenting adult is also, presumably, someone who understands what he or she is being asked to consent to. But not in one Florida appeals court. A recent court decision in Florida concerning a 92-year-old woman’s signature on her nursing home contract changes the basic premise of what it means….
Continue ReadingEnd of Life
Choosing a Doctor for an Elderly Patient
Gerontology is the study of health issues that go with old age and aging. It’s a medical specialty because, like the very young, older people have different biological, psychological and sociological needs. Medicare, the health insurance program that covers people in the U.S. starting at age 65, addresses many of the financial concerns of this….
Continue ReadingDoctors’ Failure to Communicate Can Make Patients Sicker
Chemotherapy, a frontline treatment for many forms of cancer, uses chemical agents to stop fast-growing cells from multiplying. That includes cancer cells, but also other fast-growing cells, which is why it has so many side effects. The chemicals do not discriminate between what’s cancer and what isn’t. Although chemotherapy sometimes can halt the progress of….
Continue ReadingFreedom and the “Right to Die”
Today, I offer some very personal musings about how we treat disabled people in our laws. One recurring theme in this patient safety blog is to promote self-determination for patients as the best guide through a tortuous, mistake-prone medical care system. If you learn enough about your own condition, that will help you get the….
Continue ReadingDoctors Die More Gently Than the Rest of Us
Late last year, Zócalo, an online public square that encourages the exchange of ideas, published an essay called “How Doctors Die,” by Dr. Ken Murray, a professor of medicine at the University of Southern California. Personal, heartfelt and utterly illuminating, the essay describes how our culture extends the lives of the elderly and the terminal….
Continue ReadingPlanning for the End: An Essential Piece of Quality Health Care
Our own mortality lurks offstage, way offstage we hope, and yet one piece of it is something we can and should bring onstage: a plan for safe, high quality and humane medical care at the very end. Because if we don’t plan now, things could go dreadfully off the tracks later, at a time when….
Continue ReadingAricept 23—A Misleading Drug Enabled by the FDA
In some ways, Alzheimer’s is like arthritis. Its symptoms can wax and wane, making it difficult to determine if a particular treatment is successful. Who’s to say if a symptom subsided because a drug worked or because it was going to diminish anyway? And, like arthritis, Alzheimer’s cannot be cured, only moderated. That can lead….
Continue ReadingWas Steve Jobs’ Death Hastened by “Magical Thinking”?
The question will never be answered with any certainty. But it’s worth thinking about, because many of us will eventually be required to make our own hard choices about what kind of treatment to get for a scary disease. The known facts about Jobs are these. He had an unusual form of slow-growing cancer of….
Continue ReadingThe Growth of Palliative Care in Hospitals
Paralleling the growth of the hospice industry, the number of hospital-based palliative care programs has more than doubled since 2000. According to a new survey by the Center to Advance Palliative Care, nearly two-thirds of hospitals surveyed had palliative care teams. Palliative care focuses on easing the symptoms, stress and pain of serious illness, whether….
Continue ReadingPatients Deserve Compassion, but Can It Be Taught to Doctors?
Every patient and every doctor know that delivering bad news is something that physicians sometimes have to do. But too many doctors don’t realize that the way they communicate can cause terrible and needless emotional injury. A flat, heartless delivery of bad news can make patients feel abandoned and devastated. A touch of compassion, on….
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