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A do-not-resuscitate order (DNR), also known as Do Not Attempt Resuscitation (DNAR), Do Not Attempt Cardiopulmonary Resuscitation (DNACPR), no code or allow natural death, is a medical order, written or oral depending on the jurisdiction, indicating that a person should not receive cardiopulmonary resuscitation (CPR) if that person's heart stops beating. Sometimes these decisions and the relevant documents also encompass decisions around other critical or life-prolonging medical interventions. The legal status and processes surrounding DNR orders vary in different polities. Most commonly, the order is placed by a physician based on a combination of medical judgement and patient involvement.
Medical ethics is an applied branch of ethics which analyzes the practice of clinical medicine and related scientific research. Medical ethics is based on a set of values that professionals can refer to in the case of any confusion or conflict. These values include the respect for autonomy, non-maleficence, beneficence, and justice. Such tenets may allow doctors, care providers, and families to create a treatment plan and work towards the same common goal. These four values are not ranked in order of importance or relevance and they all encompass values pertaining to medical ethics. However, a conflict may arise leading to the need for hierarchy in an ethical system, such that some moral elements overrule others with the purpose of applying the best moral judgement to a difficult medical situation. Medical ethics is particularly relevant in decisions regarding involuntary treatment and involuntary commitment.
Life support comprises the treatments and techniques performed in an emergency in order to support life after the failure of one or more vital organs. Healthcare providers and emergency medical technicians are generally certified to perform basic and advanced life support procedures; however, basic life support is sometimes provided at the scene of an emergency by family members or bystanders before emergency services arrive. In the case of cardiac injuries, cardiopulmonary resuscitation is initiated by bystanders or family members 25% of the time. Basic life support techniques, such as performing CPR on a victim of cardiac arrest, can double or even triple that patient's chance of survival. Other types of basic life support include relief from choking, staunching of bleeding by direct compression and elevation above the heart, first aid, and the use of an automated external defibrillator.
Palliative care is an interdisciplinary medical caregiving approach aimed at optimizing quality of life and mitigating suffering among people with serious, complex, and often terminal illnesses. Within the published literature, many definitions of palliative care exist. The World Health Organization (WHO) describes palliative care as "an approach that improves the quality of life of patients and their families facing the problems associated with life-threatening illness, through the prevention and relief of suffering by means of early identification and impeccable assessment and treatment of pain, illnesses including other problems whether physical, psychosocial, and spiritual". In the past, palliative care was a disease specific approach, but today the WHO takes a broader patient-centered approach that suggests that the principles of palliative care should be applied as early as possible to any chronic and ultimately fatal illness. This shift was important because if a disease-oriented approach is followed, the needs and preferences of the patient are not fully met and aspects of care, such as pain, quality of life, and social support, as well as spiritual and emotional needs, fail to be addressed. Rather, a patient-centered model prioritizes relief of suffering and tailors care to increase the quality of life for terminally ill patients.
The Terri Schiavo case was a series of court and legislative actions in the United States from 1998 to 2005, regarding the care of Theresa Marie Schiavo, a woman in an irreversible persistent vegetative state. Schiavo's husband and legal guardian argued that Schiavo would not have wanted prolonged artificial life support without the prospect of recovery, and, in 1998, he elected to remove her feeding tube. Schiavo's parents disputed her husband's assertions and challenged Schiavo's medical diagnosis, arguing in favor of continuing artificial nutrition and hydration. The highly publicized and prolonged series of legal challenges presented by her parents, which ultimately involved state and federal politicians up to the level of George W. Bush, the then U.S. president, caused a seven-year delay before Schiavo's feeding tube was ultimately removed.
Terminal illness or end-stage disease is a disease that cannot be cured or adequately treated and is expected to result in the death of the patient. This term is more commonly used for progressive diseases such as cancer, dementia, advanced heart disease, and for HIV/AIDS, or long COVID in bad cases, rather than for injury. In popular use, it indicates a disease that will progress until death with near absolute certainty, regardless of treatment. A patient who has such an illness may be referred to as a terminal patient, terminally ill or simply as being terminal. There is no standardized life expectancy for a patient to be considered terminal, although it is generally months or less. Life expectancy for terminal patients is a rough estimate given by the physician based on previous data and does not always reflect true longevity. An illness which is lifelong but not fatal is a chronic condition.
The Lanterman–Petris–Short (LPS) Act regulates involuntary civil commitment to a mental health institution in the state of California. The act set the precedent for modern mental health commitment procedures in the United States. The bipartisan bill was co-authored by California State Assemblyman Frank D. Lanterman (R) and California State Senators Nicholas C. Petris (D) and Alan Short (D), and signed into law in 1967 by Governor Ronald Reagan. The Act went into full effect on July 1, 1972. It cited seven articles of intent:
Maria Korp was a Portuguese-born Australian woman reported missing for four days and later found, barely alive, in the boot of her car on 13 February 2005. She spent a short time in a coma before emerging into a state of post-coma unresponsiveness. She became the centre of a controversy in Australia during 2005. Depending upon their viewpoint, people have characterised the controversy as being about euthanasia or about human rights and protecting people with disabilities.
The Association of American Physicians and Surgeons (AAPS) is a politically conservative non-profit association that promotes conspiracy theories and medical misinformation, such as HIV/AIDS denialism, the abortion–breast cancer hypothesis, and vaccine and autism connections, through its official publication, the Journal of American Physicians and Surgeons. The association was founded in 1943 to oppose a government attempt to nationalize health care. The group has included notable members, including American Republican politicians Ron Paul, Rand Paul and Tom Price.
The Baby Doe Law or Baby Doe Amendment is an amendment to the Child Abuse Prevention and Treatment Act of 1974, passed in 1984, that sets forth specific criteria and guidelines for the treatment of disabled newborns in the United States, regardless of the wishes of the parents.
The Ashley Treatment refers to a controversial set of medical procedures performed on an American child, "Ashley X". Ashley, born in 1997, has severe developmental disabilities due to static encephalopathy; she is assumed to be at an infant level mentally, but continues to grow physically. The treatment included growth attenuation via high-dose estrogens, hysterectomy, bilateral breast bud removal, and appendectomy. In June 2016, after 18 years of searching, Ashley's condition was determined to be the result of a de novo and non-mosaic single-nucleotide polymorphism in the GRIN1 gene, which is implicated in neurotransmission.
The Liverpool Care Pathway for the Dying Patient (LCP) was a care pathway in the United Kingdom covering palliative care options for patients in the final days or hours of life. It was developed to help doctors and nurses provide quality end-of-life care, to transfer quality end-of-life care from the hospice to hospital setting. The LCP is no longer in routine use after public concerns regarding its nature. Alternative methodologies for Advance care planning are now in place to ensure patients are able to have dignity in their final hours of life. Hospitals were also provided cash incentives to achieve targets for the number of patients placed on the LCP.
Carmel Cryan is an English actress, known for the role of Brenda Boyle in the BBC soap opera EastEnders. She was the wife of the actor Roy Kinnear (1934–1988).
The Family Health Care Decisions Act is a New York State statute that enables a patient's family member or close friend to make health care treatment decisions if the patient lacks capacity and did not make the decision in advance or appoint a health care agent. It also creates a bedside process to determine patient incapacity; a priority list for the selection of the decision-maker; and ethical standards for making decisions, including life-sustaining treatment decisions. In short, it empowers a surrogate decision-maker for health care decisions for incapable patients in New York.
Ableism is discrimination and social prejudice against people with physical or mental disabilities. Ableism characterizes people as they are defined by their disabilities and it also classifies disabled people as people who are inferior to non-disabled people. On this basis, people are assigned or denied certain perceived abilities, skills, or character orientations.
The Texas Advance Directives Act (1999), also known as the Texas Futile Care Law, describes certain provisions that are now Chapter 166 of the Texas Health and Safety Code. Controversy over these provisions mainly centers on Section 166.046, Subsection (e),1 which allows a health care facility to discontinue life-sustaining treatment ten days after giving written notice if the continuation of life-sustaining treatment is considered futile care by the treating medical team.
This disability rights timeline lists events relating to the civil rights of people with disabilities in the United States of America, including court decisions, the passage of legislation, activists' actions, significant abuses of people with disabilities, and the founding of various organizations. Although the disability rights movement itself began in the 1960s, advocacy for the rights of people with disabilities started much earlier and continues to the present.
Dinesh Palipana is an Australian doctor, lawyer, scientist and disability advocate. He is the first quadriplegic medical intern in Queensland, Australia. He is the second person with quadriplegia to graduate as a doctor in Australia and the first with spinal cord injury.
The Charlie Gard case was a best interests case in 2017 involving Charles Matthew William "Charlie" Gard, an infant boy from London, born with mitochondrial DNA depletion syndrome (MDDS), a rare genetic disorder that causes progressive brain damage and muscle failure. MDDS has no treatment and usually causes death in infancy. The case became controversial because the medical team and parents disagreed about whether experimental treatment was in the best interests of the child.
Baby M was the pseudonym of an Australian girl named Allison who was born with severe birth defects, whose treatment and eventual death caused significant controversy and international discussion about the medical ethics of disabled newborns. Right to Life activists accused her parents and the hospital of murdering the infant, leading to a lengthy legal inquest.
References
- ↑ EDT, Emily Czachor On 7/2/20 at 11:28 AM (July 2, 2020). "Black disabled man in Texas dies after being denied COVID treatment and starved for six days, wife alleges". Newsweek.
{{cite web}}: CS1 maint: numeric names: authors list (link) - ↑ Streicher, Brad (June 2, 2020). "Quadriplegic patient dies of COVID-19 after Austin hospital, guardian decide against life-saving treatment". KVUE.com.
- ↑ Rousselle, Christine (July 1, 2020). "'An affront to human dignity': Ethicists react to death of Michael Hickson". Catholic News Agency.
- 1 2 3 4 5 6 7 8 9 Roberts, Kim (June 29, 2020). "Austin Hospital Withheld Treatment from Disabled Man Who Contracted Coronavirus". The Texan.
- ↑ "Newsroom". St. David's HealthCare.
- ↑ "Statement on the Passing of Michael Hickson". Family Eldercare. June 30, 2020.
- ↑ "NCD Chairman statement on death of Michael Hickson". National Council on Disability. July 2, 2020.
- ↑ "Texas Legislature Online - 87(R) History for HB 3063".
- ↑ Kim Roberts (April 7, 2021). "Disabled Texas Man's Death Could Lead to New Protections for End-of-Life Decisions". The Texan.