Browsing by Subject "death"

Now showing 1 - 8 of 8
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    Defining death: a report on the medical, legal and ethical issues in the determination of death
    (1981-07) United States. President’s Commission for the Study of Ethical Problems in Medicine and Biomedical and Behavioral Research
    Studies the criteria for defining "death", and recommends that a legal definition of "death" be established.
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    Defining end-stage renal disease in clinical trials: a framework for adjudication
    (Oxford, 2016-06) Agarwal, Rajiv; Department of Medicine, IU School of Medicine
    Unlike definition of stroke and myocardial infarction, there is no uniformly agreed upon definition to adjudicate end-stage renal disease (ESRD). ESRD remains the most unambiguous and clinically relevant end point for clinical trialists, regulators, payers and patients with chronic kidney disease. The prescription of dialysis to patients with advanced chronic kidney disease is subjective and great variations exist among physicians and countries. Given the difficulties in diagnosing ESRD, the presence of estimated GFR <15 mL/min/1.7 3m2 itself has been suggested as an end point. However, this definition is still a surrogate since many patients may live years without being symptomatic or needing dialysis. The purpose of this report is to describe a framework to define when the kidney function ends and when ESRD can be adjudicated. Discussed in this report are (i) the importance of diagnosing symptomatic uremia or advanced asymptomatic uremia thus establishing the need for dialysis; (ii) establishing the chronicity of dialysis so as to distinguish it from acute dialysis; (iii) establishing ESRD when dialysis is unavailable, refused or considered futile and (iv) the adjudication process. Several challenges and ambiguities that emerge in clinical trials and their possible solutions are provided. The criteria proposed herein may help to standardize the definition of ESRD and reduce the variability in adjudicating the most important renal end point in clinical trials of chronic kidney disease.
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    Experiences of Female and Male Medical Students With Death, Dying, and Palliative Care: One Size Does Not Fit All
    (Sage, 2018-06) Hoffman, Leslie A.; Mehta, Rakesh; Vu, T. Robert; Frankel, Richard M.; Anatomy and Cell Biology, School of Medicine
    Background: Medical students learn about death, dying, and palliative care (DDPC) through formal curricular offerings and informal clinical experiences; however, the lessons learned in the clinic may be at odds with the formal curriculum. Reflective writing is a means for students to “bracket” their DDPC experiences and reconcile conflicts between the formal and informal curriculum. Objectives: The aim of this study is to compare the level of reflection demonstrated in medical students’ narratives on DDPC with other experiences and to examine the domains of professionalism that students perceive to be prevalent in their DDPC experiences. Methods: Third-year medical students submitted professionalism narratives during their internal medicine clerkship. We identified a subset of narratives related to DDPC (n = 388) and randomly selected control narratives (n = 153). We assessed the level of reflection demonstrated in the narratives using a validated rubric and analyzed the professionalism domains that students identified as relevant to their experience. Results: There was no difference in reflective level between DDPC and control narratives. Within the DDPC group, female students demonstrated higher reflection (2.24 ± 0.71) than male students (2.01 ± 0.77; P < .001). Caring, compassion and communication, and honor and integrity were prominent among DDPC narratives. More females identified caring, compassion, and communication as relevant to their DDPC experiences, whereas more males identified altruism. Conclusion: Males and females have different perceptions of DDPC experiences, and female students appear to be more deeply impacted. These findings can help clinical faculty engage students more effectively with this challenging topic.
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    Let’s break the silence about miscarriages
    (2014-10-10) Bute, Jennifer J.; Brann, Maria
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    Potentiality, Possibility, and the Irreversibility of Death
    (Philosophy Education Society, Inc., 2008-09) Eberl, Jason T.
    In this paper, I will consider the case of cryopreservation. A central conceptual focus throughout this discussion is the purportedly irreversible nature of death and the criteria by which a human body is considered to be informed by a rational soul.
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    The Role of Marriage in the Causal Pathway from Economic Conditions Early in Life to Mortality
    (Elsevier, 2015-03) van den Berg, Gerard J.; Gupta, Sumedha; Department of Economics, School of Liberal Arts
    This paper analyzes the interplay between early-life conditions and marital status, as determinants of adult mortality. We use individual data from Dutch registers (years 1815–2000), combined with business cycle conditions in childhood as indicators of early-life conditions. The empirical analysis estimates bivariate duration models of marriage and mortality, allowing for unobserved heterogeneity. Results show that conditions around birth and school going ages are important for marriage and mortality. Men typically enjoy a protective effect of marriage, whereas women suffer during childbearing ages. However, having been born under favorable economic conditions reduces female mortality during childbearing ages.
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    Social Work Should Be More Proactive in Addressing the Need to Plan for End of Life
    (Oxford, 2016-11) Johnson, Kimberly J.; Hong, Michin; Inoue, Megumi; Adamek, Margaret E.; School of Social Work
    Few people engage in planning for life’s end and the prevalence of preparedness is particularly low in ethnic communities. As a profession, social work is well equipped to help increase planning for life’s end and the care people wish to receive. However, the profession cannot simply defer to those in hospice and palliative care settings to address this issue. There is a need for earlier and equitable access to death preparation, and social workers can be instrumental in helping to insure equal opportunities for proactive planning for death. The ways social work may become more proactive in assisting individuals and families to prepare for the end-of-life are discussed.
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    A Thomistic Understanding of Human Death
    (Blackwell Publishing, 2005-01-17) Eberl, Jason T.
    I will review higher-brain and whole-brain death from the standpoint of Thomas Aquinas’s metaphysical understanding of human nature. I will critique arguments for higher-brain death being a proper interpretation of Aquinas’s views and make a case for whole-brain death to be compatible with Aquinas’s account of human death given current biological data.