Magnus has followed the case for several years and has been widely
interviewed about the issues it raises.
Q: As you look over this national debate, has it been good or bad
for the country?
Magnus: A bit of both. For more information, please
visit the Web site of the medical center's Office of Communication +
Public Affairs at http://mednews.

Sites related to the issues surrounding Death and Dying.

hallucinations curiosities

com/jpm
Terminally ill cancer patients often fear that if their pain and
suffering become unbearable conventional pain relief strategies will
not be effective. For information, contact
650-723-5760.

epitaphs curiosities

liebertpub.
"The drive for physician-assisted suicide is substantially
diminished when the public and their physicians know about this
medical development," says Charles F.,
Editor -in-Chief of Journal of Palliative Medicine., is a privately held, fully integrated
media company known for establishing authoritative peer-reviewed
journals in many promising areas of science and biomedical research,
including AIDS Patient Care and STDs, Disease Management, and The
Journal of Alternative and Complementary Medicine.
The speakers will be David Magnus, PhD, director of the Stanford
Center for Biomedical Ethics, and Deborah Rhode, JD, director of the
Stanford Center on Ethics. In
California, the treating physician is responsible for selecting an
appropriate surrogate based on several criteria to determine the
person most likely to do what the patient would want.

painless dying

com

curiosities contemplate

But two case studies report that controlled
sedation, in which sedative drugs are prescribed in doses designed to
reduce awareness of physical symptoms and psychological distress , can
be used near the end of life to alleviate symptoms that do not respond
to maximal medical therapy.
The failure to present the case in this way gave rise to a lot of
irrelevant -- and often misleading discussion -- such as whether the
patient was really in a PVS or a minimally conscious state, or whether
a gastric tube was different from ventilator support.

Stanford University Medical Center integrates research, medical
education and patient care at its three institutions -- Stanford
University School of Medicine, Stanford Hospital + Clinics and Lucile
Packard Children 's Hospital at Stanford.

hallucinations morbid

Hiroyuki Kohara, M. Living wills are actually far less help than people
realize , except in a narrow range of cases. That means the real question
in this case was about the standards we adopt for knowing what a
patient wants. On the other hand, the
topic was sensationalized and incorrectly presented as a right-to-life
issue rather than the right-to-refuse-treatment case that it actually
was.

unlocks curiosities

Brigit Taylor and Robert McCann, M., of the University of
Rochester, School of Medicine and Dentistry, in New York, present a
case study in which a terminally ill cancer patient is assured of
receiving sedation if his/her pain and physical symptoms become
severe.

agitation dying

The authors distinguish between controlled sedation to relieve
intolerable suffering and active euthanasia, defining controlled
sedation as the use of medication to bring a patient to the point of
unconsciousness to relieve intolerable suffering before an inevitable
death, but not to hasten or bring about death . Gastric tubes are
invasive medical interventions, and patients have a right to refuse
medical treatments.

morbid painless

Major symptoms requiring sedation were severe shortness
of breath, pain, agitation, and nausea/vomiting. von Gunten, M. The most important thing
is for a person to have conversations with family members about
his/her values and what he/she would want in a range of cases, and to
designate a decision maker in an advanced directive. First, it was not made sufficiently clear that patients
have a basic right to refuse treatment. States such as Missouri
and Pennsylvania have decided that life (even in a persistent
vegetative state, or PVS) is so valuable that clear and compelling
evidence is required before a surrogate can authorize discontinuing
treatment.stanford.

epitaphs delirium

The papers are available free online at
www., from the Palliative Care Unit of the
National Sanyo Hospital in Yamaguchi , Japan, and colleagues report on
the effectiveness of sedation in relieving severe, physical symptoms
in terminally ill cancer patients and the effects of sedation on
consciousness.D. Patients have the right to refuse treatment,
and we try our best to ascertain what they would want to do given
their situation.edu

omnipresent epitaphs

Y., Ph.
Q: In such cases, how do you reach conclusions as to whether it is
ethical to keep a patient alive?
Magnus: The key is to do the best we can to respect the values and
wishes of the patient.

stressful demystifying

How so?
Magnus: In Florida, there is an assumption about who would be the
appropriate person to say what the patient would want. In addition,
California has a very different standard that makes it easier for
hospitals to discontinue treatment believed to be medically
inappropriate. States such as Florida are neutral between being in a PVS
and no longer living, and so less evidence is required to authorize
discontinuing treatment.

vegetative kearl

Q: California law differs from Florida in dealing with end-of-life
decisions. Different value systems get embodied into state law,
and the laws basically fall into three types. It is good for people to recognize that
they need to have conversations with their loved ones to ensure that
their wishes and values will be respected.

kearl unlocks

Business Editors/Biotech Writers

LARCHMONT, N.D.

Media Advisory: Ethics Surrounding Schiavo Case to Be Discussed at Stanford Public Forum

hallucinations curiosities

Controlled Sedation to Treat Pain and Severe Physical Symptoms in Terminally Ill Patients Explored in Journal of Palliative Medicine

----Knowing that
effective relief from severe pain and distress at the end of life is
available will bring comfort to patients who may worry that nothing
can be done to ease their suffering, report the authors of two papers
in the February issue (Volume 8, Number 1) of Journal of Palliative
Medicine , a peer-reviewed publication of Mary Ann Liebert, Inc. Its biotechnology
trade magazine, Genetic Engineering News (GEN), was the first in its
field and is today the industry's most widely read publication
worldwide. Her parents reject that
assertion and lodged several unsuccessful appeals to try to have the
feeding tube reinserted. That would be like saying that when we remove
ventilator support we are suffocating someone.
Q: What bothered you the most about the way the media played the
story?
Magnus: There were so many ways in which the coverage was
misleading.

curiosities kearl

The medication used has a calming,
sedating effect, allowing patients to approach the end of life in a
peaceful state .
Schiavo is the Florida woman whose feeding tube was removed March
18 after a court accepted her husband's contention that she wouldn't
want to be kept alive by artificial means. Below is a Q+A with Magnus on
the Schiavo case:
Question: The term, "starving her to death," was used many times
to describe what would happen when the feeding tube was removed from
Terri Schiavo. Palliative care experts
have established that discontinuing hydration and nutrition is one of
the most painless ways for someone's life to end.

unlocks delirium

D.

expectancy hallucinations

----The legal and
ethical dilemmas surrounding the Terri Schiavo case will be the
subject of a panel discussion at noon Thursday at the Stanford
University School of Medicine.

painless omnipresent

D.
Mary Ann Liebert, Inc. The presentation, titled "When Life
Should End: Who Should Decide," will take place in room M-104 of the
Alway Building.

unlocks delirium

, and
the official journal of the American Academy of Hospice and Palliative
Medicine. The discussion will be moderated by Julie
Parsonnet , MD, senior associate dean for medical education.

agitation dying

morbid dying

, Ph.

News Editors/Health/Medical Writers

STANFORD, Calif. So the spouse
is the decision maker unless there is reason to believe that the
spouse is not doing what the patient would have wanted (if there is no
spouse, then adult children; if no adult children, then parents).

expectancy unlocks

A complete list of the firm's 60 journals, newsmagazines,
and books is available at www. Then there are states such as California that
have basically said life in a PVS is not a worthwhile goal for
medicine. Hospitals are not required to offer such treatment , though
patients are given the opportunity to find other institutions that
will allow them the treatment they desire.

resurrector contemplate

D.liebertpub. Is that an accurate description?
Magnus: Not at all. The one exception
to the rule (that we try to do what the patient wants) is that we do
not always offer treatments that are medically ineffective.

deepen undertaker

The panel discussion is sponsored by the Center for Biomedical
Ethics and is free and open to the public. It was pretty clear early on that this case was going to be a lot
more about politics than about how end-of-life decisions should be
made. The fact that the actions by the Florida legislature and by
Congress had to do with one patient -- and not the system --
highlights that Terri Schiavo was used to score political points
rather than to seriously address the topic.

demystifying thanatology

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- - kjjkjk

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