In Retrospect: What the Media Did Wrong in Covering Ashley X

Labels: Art Caplan, Ashley X, Poynter Institute
Labels: Art Caplan, Ashley X, Poynter Institute
Even though Medicaid, Wiltz's insurer, would cover all medical fees, including a blood test to determine whether she could receive Stage's kidney, Inglese said transferring deputy sheriffs to a hospital to guard Stage around the clock would be a drain on the department's already tight budget and leave the prison vulnerable.- Arthur CaplanThat money "is the taxpayers' money," he said. "The Orleans Parish Criminal Sheriff's Office doesn't have the right to donate that money so someone can have a kidney transplant. . . . We need the money for people in the jail to receive health care, not people in the community."
Labels: Art Caplan, no right to donate, organ donation, prisoners, vulnerable subject populations
Art Caplan has closed out the year in bioethics on MSNBC, the last web news Op Ed column (CNN and ABC have both closed up shop in bioethics).
Betterhumans, the transhumanist blog, identifies this as its top story as the year, a review of the potential for a drug called rimonabant to prevent cravings for cigarettes and food.
Labels: Art Caplan, Betterhumans, hodge-podge, year in review
Labels: Art Caplan, hESC, intentional obfuscation, neocon bioethics, stem cell research, stiff drinks, Wesley Smith
Labels: Art Caplan, pigs, transplants, xenotransplantation
Beating up on the pursuit of perfection is silly. As Salvadore Dali famously pointed out, “Have no fear of perfection—you'll never reach it.” Critics of those who allegedly seek to perfect human beings know this. While often couching their critiques in language that assails the pursuit of perfection, what they really are attacking is the far more oft-expressed—albeit far less lofty—desire to improve or enhance a particular behavior or trait by the application of emerging biomedical knowledge in genetics, neuroscience, pharmacology, and physiology.And Elliott responds that it isn't a conservative defense of human nature that motivates him, rather he is concerned about misplaced energies devoted to enhancement instead of more important aims; in particular Elliott is as always primarily fighting against big pharma's promotion of enhancement:
Caplan does not defend medical enhancement so much as attack its critics. Or rather, he attacks a small group of conservative critics who want to preserve “human nature.” He dispatches those critics with admirable precision, but I am not sure why he believes that group of critics includes me. My worry about enhancement technologies has little to do with human nature. My worry is that we will ignore important human needs at the expense of frivolous human desires; that dominant social norms will crowd out those of the minority; that the self-improvement agenda will be set not by individuals, but by powerful corporate interests; and that in the pursuit of betterment, we will actually make ourselves worse off.Still, it is a fun read. And maybe it will get a few more copies of Better than Well and The Perfect Baby into circulation. Come to think of it, maybe we could stage a series of these wrestling matches ... yeah ... that's the ticket ...
Labels: Art Caplan, big pharma, Carl Elliot, enhancement, GATTACA, genomics, human nature, novel funding methods, pharmaceutical industry, public intellectuals
Labels: Art Caplan, bioethics on broadway, cloning, theater
Is it necessarily the right choice to apply advanced medical technology to animals? Is it really the best option for the animal involved? And is it always the right choice for the pet owner, who might in some cases accrue staggering veterinary bills?[thanks Art Caplan]
Labels: Art Caplan, chemo for your pet?, quality of life, staggering medical bills, treating animals, when to treat
Labels: Art Caplan, creationism, education, ethical challenges, evolution, religion, silence is not always golden, textbook disclaimers
HOSPITAL, WIFE BATTLE OVER PATIENT'S LIFE A HEARING IN ORANGE WILL CONSIDER THE FATE OF A CLERMONT MAN WHO HAS A LIVING WILL. BY ANTHONY COLAROSSI | SENTINEL STAFF WRITER POSTED NOVEMBER 18, 2004Hanford Pinette made his wishes clear in a living will: He never wanted to be kept alive by a machine.
Today Pinette, 73, lies in an Orlando hospital, where machines run his lungs and kidneys. Doctors see an unresponsive patient with no hope of recovery. Alice Pinette sees her husband of 53 years clinging to life.
Now the Clermont man's fate will be fought out in a courtroom in an unusual battle waged by Orlando Regional Healthcare System officials, who want to let him die, against Alice Pinette, who wants to keep him alive.
"They're just trying to pull the plugs," Alice Pinette, 73, said Wednesday, standing in the doorway of her home. "He still communicates with me, and I won't let them do it."
A hearing in the case is scheduled for Tuesday before Orange Circuit Court Judge Lawrence Kirkwood. The outcome could have broad implications on the enforcement of living wills, which are supposed to remove uncertainty about a patient's wishes in the event of a terminal illness and incapacity.
Paul Malley, president of the Tallahassee-based Aging With Dignity, a national organization that advises people about the benefits of living wills, said he could not recall a Florida hospital going to court to enforce a written living will over the wishes of a patient's family.
"It's definitely highly unusual for a hospital to bring up a case like this," Malley said. "Where this case is, is a real challenge. There may not be an easy answer here."
The argument doesn't center on Pinette's wishes, but whether he's sick enough to carry them out.
"He's all right," Alice Pinette said. "He's getting better, a little each day." David L. Evans, Orlando Regional Healthcare's lawyer, said the hospital maintains Pinette will not get better and is trying to abide by the patient's wishes.
"All we can do is come in and describe his medical condition and his competency," Evans said last week. "We're just doing what we feel we're legally obligated to do."
The Pinette matter is almost a reversal of the Terri Schiavo case.
Schiavo collapsed 14 years ago and is now in a Clearwater nursing home in what doctors call a progressive vegetative state. She is kept alive by a feeding tube and left no written directive of her wishes.
Schiavo's husband, Michael, contends his wife told him she would not want to be kept alive. Her parents, Bob and Mary Schindler, have battled Schiavo in court, arguing their daughter is aware of her surroundings.
The case sparked a national controversy when Gov. Jeb Bush and the Florida Legislature intervened to block a court order removing Terri Schiavo's feeding tube. The courts ruled in Michael Schiavo's favor and the case remains on appeal in Florida's courts.
The case has been cited as an example of why people need to write living wills.
Pinette, a Korean War veteran and government engineer who moved to Clermont in 1994 from Maryland to retire, wrote a living will in 1998 and assigned his wife to carry out his wishes, designating her as his "surrogate."
In the event of a terminal condition with no probability of recovery, Pinette stated: "I direct that life-prolonging procedures be withheld or withdrawn when the application of such procedures would serve only to prolong the process of dying."
Pinette stated in the will that he wanted "to die naturally" and receive medication only to "alleviate pain."
But Alice Pinette produced a durable power of attorney signed by her husband on the same date in 1998.
The power of attorney states her husband assigned her "to decide for me [Hanford Pinette] any matters regarding my health care, including, but not limited to, consenting to withhold or withdraw life-prolonging procedures."
Earlier this year, Pinette suffered congestive heart failure, his wife said. He has been hospitalized since February, according to the petition filed by Orlando Regional Healthcare, and is currently at Lucerne Hospital.
Despite Alice Pinette's assertions that her husband is not terminally ill, the hospital argues in court documents that Pinette's "renal system, respiratory system and cardiovascular system are all being supported by artificial means alone."
The petition also says Pinette is not competent to make his own decisions and is not likely to recover his mental capacity. The hospital's bioethics committee which reviews cases such as this also agreed to withdraw life support.
And two doctors -- Sanjay Muttreja and Juan Herran -- submitted affidavits that Pinette is terminally ill and has no "medical probability" of recovering.
"It is my opinion as Mr. Pinette's treating physician that Mr. Pinette meets the requirements of his living will," Muttreja said in his affidavit.
But Alice Pinette, who goes to the hospital daily, said her husband "still communicates with me."
She said Pinette squeezes her hand, shakes his head and has indicated that "he wants to go home."
That is proof enough to her that he's not terminally ill.
"There's a lot of people they say that about, and it's not true," she said. "They've been after me since July to put him down."
Robert Wilkins, a Maitland attorney whose practice includes living wills, said Alice Pinette is fighting an uphill battle.
"You should be able to control your own destiny and a surrogate shouldn't be able to override that," Wilkins said. "It really isn't her prerogative, it seems to me, to disregard that."
Wilkins said Alice Pinette's best hope is if her attorney can successfully argue that the living will is invalid.
Alice Pinette's attorney, William E. Ruffier, could not be reached for comment Wednesday.
Malley, the Aging With Dignity president, said the case may help others avoid this situation by talking about living wills and the responsibilities of the surrogate before it's too late.
The best person to be someone's surrogate, for instance, might not be his or her spouse, Malley said.
"It's a difficult situation," Malley said. "But it can be avoided with other families."
Labels: Art Caplan, DNR, do not treat, Florida, legal hearing, life support, living wills, not-Schiavo, pain management, palliative care, quality of life, terminal illness
Labels: Art Caplan, clinical decision making, defining death, dying to live, organ donation, organ transplants, scarcity
Labels: Art Caplan, Bush, Illinois, research bans, state stem cell politics
Labels: Art Caplan, big medicine, cynicism, health insurance coverage, kindness deficit, uninsured
Labels: Art Caplan, embryonic stem cell research, hESC, President's Council on Bioethics, Spain
Labels: Art Caplan, bad science, Bush, Leon Kass, neocon bioethics, psuedoscience, Union of Concerned Scientists
Labels: Art Caplan, bioethics on broadway, Francis Collins, J. Craig Venter, theater
Labels: Art Caplan, buying organs, George Annas, matchingdonors.com, organ transplants
Labels: Art Caplan, New York Times, vaccines
Labels: Art Caplan, ethics of politics, hESC, stem cell research
Labels: Art Caplan, Bush, hESC, politics, stem cell research