218 research outputs found
In the Laboratory of the States: The Progress of \u3cem\u3eGlucksberg\u3c/em\u3e\u27s Invitation to States to Address End-of-Life Choice
It has now been ten years since the Supreme Court handed down Glucksberg and Quill, rulings on laws that forbid assisted suicide. In that time, normative and legal developments in the fields of law, medicine, and psychology have changed the landscape of the discourse on the choice of a mentally competent, terminally ill individual to choose to self-administer medications to bring about a peaceful death. Although the Court rejected petitioners\u27 claims that state laws denying them the ability to end their terminal illnesses through self-administered medication violated the Constitution, it left states with the opportunity to experiment with legislation that would allow terminally ill individuals the choices they had previously sought through litigation. Oregon\u27s experience with its Death with Dignity Act, which grants terminally ill, mentally competent individuals the choice to end their lives through self-administered medication, has proven that such laws provide comfort not only to those who, faced with the prospect of a horrible death from a terminal illness, choose to end their lives in a peaceful and dignified manner, but also to those to ultimately choose not to. Additionally, Oregon\u27s experience shows that the fears that originally attended the assisted suicide debate are unfounded so long as proper procedures are in place. Because Oregon\u27s Death with Dignity Act has proven both useful and harmless, this Article concludes that it is time for other states to follow Oregon\u27s lead and enact their own legislation to allow their citizens an alternative to what otherwise could be a prolonged and painful death from terminal illness
The Death with Dignity Movement: Protecting Rights and Expanding Options after Glucksberg and Quill
Surrogate End of Life Decisionmaking: The Importance of Providing Procedural Due Process, a Case Review
In a hospital in the State of Washington, at the direction of family-member surrogates, the feeding tube was withdrawn from a resident patient. The patient had no advance directive or living will, nor had he expressed the desire (previously or contemporaneously) for withdrawal of life support. He had not been diagnosed as terminally ill or permanently unconscious. In fact, there was evidence that the patient had some cognitive function, desired to continue living, and desired continued life support. This evidence was presented to his caregivers immediately after the patient was advised of the withdrawal, yet life support was not resumed until five days later, and only after a court so ordered. What happened to this patient raises fundamental questions about the procedures to be followed before life support is withdrawn from a patient who has not made an advance directive, the safeguards for ascertaining a patient\u27s condition and wishes, and the situations in which a surrogate may direct life-support removal. May hospitals and doctors terminate life support at the direction of a surrogate without assurance that the patient (a) is terminally ill or permanently unconscious, and (b) cannot make and express his or her own decision whether to live or die? Are procedural safeguards defined solely by hospitals\u27 and doctors\u27 standards of care, or must they include standards articulated by the state\u27s highest court
Privacy and Dignity at the End of LIfe: Protecting the Right of Montans to Choose Aid in Dying
Privacy and Dignity at the End of LIf
Physician Aid in Dying: A Humane Option, a Constitutionally Protected Choice
This Article presents the argument that the Fourteenth Amendment protects the individual decision to hasten death with physician-prescribed medication and that statutes prohibiting physician-assisted suicide deny equal protection, guaranteed by the Fourteenth Amendment, to competent, terminally-ill adults who are not on life support
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Relationship between social support, quality of life, and Th2 cytokines in a biobehavioral cancer survivorship trial.
ObjectiveBenefits of social support (SS) during cancer survivorship are complex. This study examines change in SS over time in cervical cancer (CXCA) survivors who have completed definitive treatment and how changing SS impacts quality of life (QOL) and T-helper type 2 (Th2) cytokines.MethodsWe conducted a randomized trial in 204 CXCA survivors to test if psychosocial telephone counseling (PTC) could improve QOL compared to usual care (UC). Although PTC did not target SS, data were collected at baseline, 4 and 9 months post-enrollment using the Medical Outcomes Survey Social Support scale. Biospecimens were collected to investigate associations with patient-reported outcomes. Data were analyzed using multivariate linear models and stepwise regression.ResultsParticipants' mean age was 43. PTC participants experienced increasing SS compared to UC at 4 months (PTC-UC = 5.1; p = 0.055) and 9 months (PTC-UC = 6.0; p = 0.046). Higher baseline SS and increasing SS were independently associated with improved QOL at 4 and 9 months after adjusting for patient characteristics (p < 0.05). Differences between study arms were not statistically significant. Improvements in QOL at 4 months were observed with increases in emotional/informational and tangible SS. Increasing SS predicted significant longitudinal decreases in IL-4 and IL-13 at 4 months that were larger in the PTC arm (interactions p = 0.041 and p = 0.057, respectively).ConclusionImproved SS was significantly associated with improved QOL independent of patient characteristics and study arm. Decreasing Th2 cytokines with increasing SS and QOL are consistent with a biobehavioral paradigm in which modulation of the chronic stress response is associated with shifts in immune stance
Predicting Preterm Birth Among Women Screened by North Carolina’s Pregnancy Medical Home Program
To determine which combination of risk factors from Community Care of North Carolina’s (CCNC) Pregnancy Medical Home (PMH) risk screening form was most predictive of preterm birth (PTB) by parity and race/ethnicity
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