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  • From coma to motherhood
    handicapped dismissed its safeguards as inadequate Medical sources however insisted its terms were reasonable The Council of Europe Convention on Human Rights and Biomedicine was signed by 21 countries but not Britain last week It allows research on people who cannot consent as long as it is research into their own condition disease or disorder that could help others with the same problem Dr Peggy Norris chairman of Against Legalised Euthanasia Research and Teaching described it as creeping euthanasia We have got to protect people who cannot give consent because they are very vulnerable and we have to be civilised enough to look after them she added The document specifies that any research on non consenting subjects should entail only minimal risk and minimal burden for the individual concerned for example taking a blood sample but apped dismissed the safeguard Klaus Lachwitz secretary general of the International League of Societies for Persons with Mental Handicaps said Unless these provisions are adequately defined this protection is meaningless Lord Ashbourne a Conservative peer who has asked questions in the House of Lords on the subject said Doctors do research for the most laudable reasons but sometimes they go too far What they are trying to do is get the door open a chink and once it s open a chink they can kick it wide open This came up with the Human Fertilisation and Embryology Bill back in 1990 They got the door open then and now we have got all sorts of things going on Britain did not sign up to the convention last week because of the election but Health Department officials said it would be considered by the next government Medical sources said its provisions were entirely reasonable and similar to the Royal College of Physicians current guidelines They said many discoveries had been possible only by allowing research on non consenting people David Morton professor of biomedical science and ethics at the University of research would be acceptable I think there are very special instances where it would not be unreasonable to consider using people in a permanent vegetative state in one way or another he said Prof Morton who is also a vet called for a national ethics committee to be set up He said animals in Britain had better protection than people when it came to research 8 April 1996 Patients in coma could be used for research SOURCE UK News Electronic Telegraph Monday 7 April 1997 Issue 682 Tougher rules on when to let coma victims die By David Fletcher Health Services Correspondent Life support dilemma for family NHS plans first surrogate birth INTERNATIONAL guidelines on how to diagnose and possibly rouse patients in deep coma are being drawn up by British doctors as evidence mounts that some patients are aware of their surroundings even though they cannot communicate It follows the case of Mark Newton 28 who was unconscious for six months after a diving accident but who disclosed on recovery that he knew

    Original URL path: http://www.chninternational.com/from_coma_to_motherhood.htm (2016-02-17)
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  • flirt Valko noted That was a woman who was supposedly totally gone in fact she was marked for no feeding Valko said that some patients are unresponsive because they are a little like turtles They withdraw out of fright Hanging On Too Long But Joanne Lynn president of Americans for Better Care for the Dying said that anyone in coma long enough to have been treated with some vigor was so unlikely to recover that an awakening would be in the range of the miraculous On the average the error is to hang on too long and put families through too much Lynn said She said that someone who had been in a coma for a few weeks or a month or two was extremely unlikely to recover and that families should act accordingly She compared dramatic coma recovery stories to tales of people who awake from the dead We do not wait three days before we bury people But neurosurgeon Dimancescu argued that misconception number one about patients in comas was the belief that once somebody s been in a coma for a week or more the situation is irreversible He added A lot of people are diagnosed in a coma when they re not They do understand some things He urged doctors to look for a response in an unusual way eye blinks one for yes two for no or they might be able to respond by moving a finger He stressed that people in comas may be able to hear The last thing to go is the hearing and the first thing to come back is the hearing What one has to do is try to be imaginative Put yourself in the position of somebody who s had a severe insult to the brain in a hospital bed probably very frightened Dimancescu said that some people are skeptical of coma stimulation because they believe that stimulation and therapy is recommended ad infinitum no matter what the person s progress is That would be a waste of resources and create false hopes in the family In practice he said intense care was usually recommended for about three months He added that doctors predictions were often wrong patients who did not seem badly injured might never recover but patients with greater injuries could awaken Valko summed it up We don t know as much as we think we do doctors and nurses Awakenings Coma Patients Can Recover by EVE TUSHNET Register Staff Writer First appeared in the National Catholic Register 12 03 00 12 09 00 Commentary by Nancy Valko Last year the glowing reports of the success of the assisted suicide law were undermined when the Kate Cheney case came to light Mrs Cheney s daughter in trying to help the euthanasia movement unintentionally hurt the movement by revealing how she pushed for assisted suicide shopped around for a willing doctor after her mom was turned down by more than one other doctor and that the final decision

    Original URL path: http://www.chninternational.com/valco.htm (2016-02-17)
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  • Can Steven Becker be Neglected to Death
    motionless man in a coma persists Death ethics With the kind of death ethics mentality promulgated by the hospitals ethics committee it isn t surprising that even Steven s hygiene has suffered When family members have seen Steven in need of a bath during their visits they have offered to bathe him themselves But even washcloths have suddenly become unavailable so family members bring their own It is outrageous that St John s ethics committee can sanction the secret denial of beneficial treatment which had helped Steven progress and fight infection while publicly continuing his feedings until a September hearing only because of a court order Even a death row inmate is allowed basic medical treatment during the appeals process Is this where the right to die has brought us St John s ethics committee seems bent on setting a speed record for such cases and has ignored the studies and news reports showing that many severely brain injured people eventually recover sometimes fully recover with time and treatment Steven s fate The family asked for this time for Steven However the ethics committee decided that Steven would not make a good enough recovery and convinced his wife Christie to accept its recommendations to end his life Other family members were offered similar counseling and meetings to induce them to accept the recommendations and thus avoid controversy but they refused Now Steven s fate will be decided by a judge Steven never chose this situation He had taken courses toward a possible future as a nurse The court appointed guardians report stated that because he was medically sophisticated enough to understand ethical dilemmas and had made alleged comments that he wouldn t want to live like people in other public right to die cases this constituted clear and convincing evidence

    Original URL path: http://www.chninternational.com/can_steven_becker_be_neglected_pt1.htm (2016-02-17)
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  • Steven Becker and the Fight for the Soul of Catholic Health Care
    that Steven had made past statements indicating that he would not want to be kept alive in his present condition Although this hearing was also closed a source told me that one of the witnesses had dated Steven when they were teenagers and testified that Steven made his comments about not wanting artificial sic nutrition and hydration while they were in the drive through lane at a fast food restaurant This testimony about past statements was offered to counteract Steven s refusal to sign an advance directive when he was admitted to the hospital The court appointed guardian not surprisingly recommended withdrawal of feedings and that Steven s wife be named his guardian In apparent defense of the need for a speedy resolution in this case the court appointed guardian said that Steven s oldest son Kyle age 6 was asking When is daddy going to leave the hospital and go to heaven According to public records Steven s wife claimed that the hospital helped her to make funeral plans after the decision to withdraw feedings was made in May and also helped her to obtain counseling on how to tell their young sons that Steven was going to die which is why the sons were allegedly asking when their daddy was going to heaven Amicus briefs filed in early September by disability legal and pro life groups citing Missouri law the refusal of the advance directive etc were rejected by the court and the judge named the wife guardian immediately after the last hearing Within days however Steven was secretly spirited out of the hospital after Archbishop Rigali had told the hospital that they could not allow the removal of feedings in such cases citing Church teaching that food and water may be withheld in only two instances when a person is actually dying and food and water can bring no comfort to that person or when the body cannot assimilate the nutrition and hydration The hospital issued a statement that in accordance with the wife s request they would not reveal where Steven was taken The mother and the rest of Steven s family obtained a restraining order against removing the feedings pending an appeal but the order could not be served because Steven was being hidden It was reported that the feedings were stopped and 5 days later on October 10 it was revealed that Steven had suddenly died at home while being attended to by a doctor nurse and priests just one hour before a judge was to issue another ruling on Steven s case The results of an autopsy were pending at this writing The circumstances of Steven s case secret transfer and sudden death are shocking but just as appalling were the responses to this case of several prominent Catholic ethicists and theologians Dominican Father Kevin O Rourke on the family s contention that Steven had some purposeful responses supported by observations in the medical records said There s always people who will say

    Original URL path: http://www.chninternational.com/steven_becker_pt2_conclu.htm (2016-02-17)
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  • Monday 8 July 2002
    to do with euthanasia or with physician assisted suicide in which a person seeks to take an action to end their life prematurely often with the help of another It is not the same as the case of Diane Pretty who has motor neurone disease and wants her husband to be free from prosecution if he helps her to end her life Her case failed in the English courts and she has taken it to the European Court of Human Rights In the case of the paralysed woman her doctors said that they had got to know her over the year Clearly they like her The bond has gone beyond the doctor patient relationship Her anaesthetist said yesterday that she did not want to take an action that would kill her patient Her consultant told how she enjoyed talking to the woman had many chats with her but said how hard it was to find anything to make her happy Her doctors believe that if she was not in the intensive care unit but cared for in different more normal surroundings she might feel differently about wanting to live Dr Vivienne Nathason head of ethics at the British Medical Association recalled that the actor Christopher Reeve had begged people to let him die when he had learned the extent of his paralysis Now he is glad that he didn t We know that with psychological support and full rehabilitation and when people go home they can feel differently But it seems to me that ethically and legally if a patient is competent she has the right to say whether or not she wants life sustaining treatment she said Dr Richard Nicholson editor of the Bulletin of Medical Ethics said it was unusual for such a case to go to court

    Original URL path: http://www.chninternational.com/rtd_when%20does%20patient%20know.htm (2016-02-17)
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  • See ME
    swells I remember the joys I remember the pain And I m loving and living life over again I think of the years all too few gone too fast And accept the stark fact that nothing can last So I open your eyes nurses open and see Not a crabby old woman look closer nurses see ME This poem was found among the possessions of an elderly lady who died in the geriatric ward of a hospital No information is available concerning her who she was or when she died Reprinted from the Assessment and Alternatives Help Guide prepared by the Colorado Foundation for Medical Care http www nursinghomealert com seeme html Note I have a hard copy of this that dates back to the early 90 s I m pleased to see it online and hope it gets wide circulation Cheryl CHN LINK Restraint reduction Note from CHN I think anyone who has a loved one or friend in long term care or nursing home should take the time to peruse this PDF file it may help to assess how your loved one is doing and help prevent possible abuse Bluebird mourns death of another I happened upon this photo quite by accident on the Internet quite a while back but its image has never left me Occasionally we hear or see birds crash into our windows in spite of all the things I ve put on our windows to help prevent such accidents I always run out with a small towel just in case it s still alive If it is alive I ll bring it in I will gently wrap it to conserve its body heat and put it in a box that I ve punched air holes in Then I cover it and place it in a warm location Thankfully some do not have injuries like broken wings and can be released after they ve come out of the shock Once I m certain they are well and alert I let them go I am filled with joy when I see them fly off Still some like this poor baby dies I ve held a few birds in the palm of my hand and helplessly watched it take its final breath I can not help but shed tears for the innocent fragile creature that lays dead in my hand I remembered the poem I had in my files but had not posted it it seemed right to pair this photograph with the poem above I remembered well what Jesus said about the sparrow falling to the ground I can not look at this photo without thinking that God was looking down on this precious creature the instant it fell How precious we are to Him This to me is a powerful image of love and mourning and the importance of See ME Cheryl Eckstein CHN Footnote less than 12 hours after writing this I heard a familiar bang coming from our kitchen so did my husband

    Original URL path: http://www.chninternational.com/see_me.htm (2016-02-17)
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  • Transplantation from non
    transplant co ordinators will have to monitor the situation carefully The energy required of a team to effect a successful transplant with urgency is considerable and the commitment of others for example pathologists would have to be agreed in advance Major logistic changes would be needed Another issue is detailed functional assessment of the organ before transplantation Steen s group has shown convincingly that detailed assessment is possible and that there is time to identify factors contraindicating use of an organ Such assessment should improve the quality of transplantation The doubtful point in Steen and colleagues paper is their view that the risk of death due to unexpected complications after transplantation is minimal and that when the graft fails an urgent call for new donor lungs and re transplantation could save the patient s life These are remote hopes complications some fatal do occur after transplantation and the chances of finding new organs are poor at least in the UK Despite this reservation Steen and colleagues report should encourage a wider ethical debate about the potential for the use of non heart beating donors For transplantation to become a successful form of therapy the supply of donors must be increased 2 Complete history of this document commentary and URL can be found in the March 17th issue of the Lancet as referred to in the reference References 1 Stig Steen Trygve Sjöberg Leif Pierre Qiuming Liao Leif Eriksson Lars Algotsson Transplantation of lungs from a non heart beating donor The Lancet Volume 357 Number 9259 17 March 2001 http www thelancet com journal vol357 iss9259 artid 15520 2 Martin J Elliott George Mallory Jnr Asgar Khagani The Lancet Volume 357 Number 9259 17 March 2001 Commentary Transplantation from non heart beating donors Lancet March 17 Volume 357 Number 9259 http www thelancet com journal vol357 iss9259 full llan 357 9259 editorial and review 15542 1 PLEASE NOTE In order to review most articles one must sign up and obtain a user ID and password I found this system to be very accessible taking only moments to complete Access can then be made to a wealth of FREE archives The URL for the LANCET HOME PAGE http www thelancet com home Editor s notes by C Eckstein C HN 06 April 2010 An article in today s BBC headlines Lung transplant breakthrough Organs can be preserved after death Scientists have found a way to increase the number of lungs available for transplant surgery Donor organs are in short supply in general in the UK but the shortage of lungs is particularly severe This is because up to 80 of potential donor organs have to be discarded because they do not work well enough This break through doesn t come without criticism While use of non heart beating donors may be of particular value in those societies in which criteria for brain death are not accepted Martin J Elliott et al also adds It should also increase the donor pool in all countries THE LANCET Volume 357 Number 9259 17 March 2001 Transplantation from non heart beating donors Lung transplantation remains an experimental procedure 92 of lung transplants are done in patients between the ages of 18 and 65 predominantly for emphysema cystic fibrosis pulmonary fibrosis and pulmonary hypertension The 5 year survival for this group is 45 50 it is worse in children Obliterative bronchiolitis is the commonest terminal event 1 Other crucial problems are supply of donor organs and the quality of their management and preservation 2 Ways of dealing with the inadequate supply range from transplanting single lungs to using live related donors 3 The use of non heart beating donors as described by Stig Steen and colleagues in today s Lancet may be of particular value in those societies in which criteria for brain death are not accepted It should also increase the donor pool in all countries However only time will tell whether organs from non heart beating donors function as well as organs from conventional donor sources especially since duration of organ ischaemia a known risk factor for death 1 can be difficult to control in such cases The potential for using organs from non heart beating donors has been emphasised before in experimental work in which all organs can be retrieved by placing patients on cardiopulmonary support even some time after death 4 Such a procedure represents a form of reanimation of potential viable organs Thus if increasing the donor supply is the primary goal such donors should be considered Steen s paper raises several important issues An important issue is consensus on the ethics of the procedure Steen s group consulted widely in Sweden and obtained agreement We are unaware of any other group having done this for therapies that raise similar issues Can the consensus that Steen obtained be applied to other societies We doubt it For example in the UK the distrust of doctors following well publicised scandals especially regarding organ retention will adversely affect this ethical framework We also wonder whether the UK media is prepared to engage in such a debate in a mature way Next those units with patients who are potential donors must be prepared to revise their thinking to allow the procedures for organ preservation and retrieval Anticipation of potential donor status the need for heparinisation at the time of death the availability of facilities for organ cooling rapid ascertainment of the wishes of patients and relatives quick access to centralised data records and willingness of the carers to allow the transplant team access to the recently deceased person are other difficulties that have to be faced Conventional practice is to separate the carers for the dying patient from the recipient team to prevent any conflicts of interest Steen and colleagues procedure seems to demand mingling of these interests so transplant co ordinators will have to monitor the situation carefully The energy required of a team to effect a successful transplant with urgency is considerable and the

    Original URL path: http://www.chninternational.com/lung_transplantation_from_non.htm (2016-02-17)
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  • Health
    the lungs of a man who died of a heart attack after a failed resuscitation attempt The man s lungs were injected through the chest with a coolant 65 minutes after he died The cooling extended the ability of the lungs to survive for at least another 12 hours Steen said in describing the method last week in The Lancet medical journal The lungs were removed after three hours Steen said Monday he considered the operation a success and the method will increase the number of organs available for transplant What happened is very unfortunate but it won t affect our future research because the woman did not die as a result of the transplant he said In fact the transplanted lung worked to the very last The patient whose identity was not released seemed to recuperate quite well from the beginning and she was out of bed just a week after surgery Steen said But her general state of health started to deteriorate after she underwent a liver operation that was unrelated to the lung transplant and contracted the virus Steen said he has permission to perform eight more transplants of the same type after which the new method

    Original URL path: http://www.chninternational.com/lung_patient_dies.htm (2016-02-17)
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