Category Archives: Bioethics Conflicts

Survival in Hospital Cardiac Arrest – Challenges for Hospitalists Standard

The September 2010 publication of “The Hospitalist” reviews the overall survival rates for cardiac arrest patients. This article reports that patients frequently have unrealistic expectations and overestimate their chances of survival. Patients predict post-arrest CPR survival at 64%, while the rate is 17%. Most important is that in nearly half of the patients who initially expressed the desire for CPR, once they were informed of the actual estimates, they changed their minds and code status was changed. It is difficult for many hospitalists to discuss DNR orders with patients. There is not a trusting relationship formed over time. Therefore it is…

Withdrawing Life Sustaining Treatment – Betancourt v Trinitas – Appellate Court Decision Standard

The New Jersey Superior Court–Appellate Division dismissed the appeal in Betancourt v Trinitas finding the appeal moot. The court stressed it’s concern over the  “sparse record” presented at the time of  the original hearing in the trial court as well as on appeal and found that the evidence was not “conclusive in several areas necessary to fully adjudicate the substantial issues raised.” This is sometimes referred to as insufficiency of evidence. If the person or entity bringing the case does not provide sufficient evidence the court will dismiss the claim. In this case Tinitas Hospital’s request to withdraw the ventilator….

Terminal Extubation: Discussion and Protocol By Bernard Freedman, Bioethicist Standard

Transparency: The salient ethical, moral and principle necessity to terminal extubation is the transparency of the conduct of all physicians and medical staff, and fundamental understanding by the patient family and or friends as to why it is being done and how it is being done. It is therefore the obligation of the primary treating physician (PMD) to assure full communication and full documentation. All must keep in mind that the critical distinguishing factor between terminal extubation and physicians assisted suicide is the patient’s rejection (by the patient of patient’s surrogate) of artificial life sustaining treatment followed by the alleviation…