Dear Friends,
As a subscriber to a HealthCare Chaplaincy publication, we are pleased to send you the “Soul of Bioethics" newsletter, which we now publish periodically. It is edited by Harry (Rick) Moody, Ph.D., director of academic affairs for AARP in Washington, DC.
Contents
- What Is Rationing?
- Leaving a Legacy
- "Dr. Hal" Will See You Now
- Baby Boomers Reach Golden Pond
- Funding Opportunity: Palliative Care & Chaplaincy
- Web Sites to See
- Books of Interest
- Freedom from Disease
WHAT IS RATIONING?
"It is beyond cruelty to have subjected our elders, especially, to groundless fear in the pure service of political agendas...Maybe a real death panel is a group of people who tell health care insurers that is it OK to take insurance away from people because they are sick or are at risk for becoming sick...
It boggles my mind that the same people who cry 'foul' about rationing an instant later argue to reduce health care benefits for the needy, to defund crucial programs of care and prevention, and to shift thousands of dollars of annual costs to people – elders, the poor, the disabled – who are least able to bear them...
"When the 17 million American children who live in poverty cannot get the immunizations and blood tests they need, that is rationing."
(From Valedictory remarks by Donald Berwick, M.D., former chief of the U.S. Center for Medicare and Medicaid Services)
LEAVING A LEGACY
"To live life to the full in social terms is to leave a legacy that might add to human culture, making it richer and more diverse. Without the development of this type of ethical position, the justification for extended life becomes problematical."
Bryan Turner, CAN WE LIVE FOREVER: A Social and Moral Inquiry, Anthem, 2009).
"DR. HAL" WILL SEE YOU NOW
Remember the artificial intelligence computer named "Hal" in the film "2001: A Space Odyssey?" Well, we're already past that date, so it's not surprising that researchers at the University of California-San Francisco are working on software to enable the docs to figure out if someone belongs in hospice (6 months survival time is the key to admission).
Using new technology, the goal is to give patients and clinicians information about the likelihood of survival. Physicians plug your numbers into the Porock index and use the results to assess assess life expectancy for nursing home residents and others. "Got congestive heart failure? What about failing kidneys? Hmmm, let's see what the outlook is..." Of course, the six month cutoff is always a probability judgment and individual differences, not to mention the "will to live," will play a role.
Some are uneasy with this new intervention. But are we really afraid of getting better information? Or does this innovation somehow symbolize our fears of a dehumanized healthcare system? The questions are worthy of debate.
To learn more, read about it at: http://www.nytimes.com/2012/01/11/health/using-interactive-tools-to-assess-the-likelihood-of-death.html
To explore the software, visit: http://www.eprognosis.org/
BABY BOOMERS REACH GOLDEN POND
The late gerontologist and geriatrician Robert Butler mused about what might happen when the Baby Boomers reach Golden Pond. On some accounts, the answer may not be a happy one.
Ethicist Daniel Callahan and physician Sherwin Nuland believe the U.S. healthcare system needs radical revision-- and their proposed solution will be controversial. In an article earlier this year, "The Quagmire: How American Medicine is Destroying Itself" (New Republic, May, 2011), they argue that the healthcare system should focus on public health and prevention for the young, and care instead of curing older people: "The real problem is that we have medicine excessively driven by progress, which aims to rid us of death and disease and treats them as the targets of unlimited medical warfare," write Callahan and Nuland.
Both Callahan and Nuland are 80 years old. Yet they argue that "the amount of money the country spends on Medicare is unsustainable. With senior citizens the fastest-growing age group in the country, they say, the only way to control the ballooning costs is to try to bring the entire population up to a life expectancy of 80 and stop using most expensive technologies and medicines to extend life beyond that, even if some people will die."
To read their argument in full, visit: http://www.tnr.com/article/economy/magazine/88631/american-medicine-health-care-costs?passthru=ZDY1YmFhOTg2YzhmMWE2Njg2MTMzNmM1OWUyYmUyMDQ
FUNDING OPPORTUNITY: PALLIATIVE CARE & CHAPLAINCY
HealthCare Chaplaincy has released a Call for Proposals (CFP) for a grantmaking initiative aimed at growing the field of chaplaincy research in palliative care.
HealthCare Chaplaincy, with support from the John Templeton Foundation, welcomes applications from interdisciplinary research teams comprised of health, behavioral or social scientists, and board-certified chaplains who are affiliated with educational or health care institutions, research organizations, or other types of nonprofit organizations located in the United States or Canada. Consortia of such institutions or organizations are also welcome to apply. HealthCare Chaplaincy will select and fund 6 to 10 interrelated and interdisciplinary research projects at a total of $1.5 million. The deadline for submitting applications is March 15, 2012 at 3 pm ET.
The Call for Proposals and additional information can be found at: http://www.healthcarechaplaincy.org/templeton-research-project.html
For additional questions, contact Robert Wolf at the HealthCare Chaplaincy at jtf-applicant@healthcarechaplaincy.org or (646) 597-6934
WEB SITES TO SEE
GENERATIONAL JUSTICE. See "Justice between Generations:
The Recent History of an Idea" at: http://www.fielding.edu/acFiles/pdf/webPages/whyFielding/CI/S1p3_Moody-final.pdf
ALZHEIMER'S AND MEMORY. Listen to the podcast of "Alzheimer’s, Memory and Being" with Alan Dienstag, interviewed by Krista Tippett on her show "On Being" (formerly "Speaking of Faith") at: http://being.publicradio.org/programs/
PALLIATIVE CARE. For thoughts about bioethics, suffering and palliation, see the article at: http://practicalbioethics.org/wp-content/uploads/2011/06/McNair_16_2.pdf
BOOKS OF INTEREST
OXFORD TEXTBOOK OF PALLIATIVE SOCIAL WORK, edited by Terry Altilio and Shirley Otis-Green (Oxford Univ. Press, 2011). Details at:
http://www.oup.com/us/catalog/general/subject/Medicine/PalliativeMedicine/?view=usa&ci=9780199739110
HOW TO BE SICK: A Buddhist-Inspired Guide for the Chronically Ill and Their Caregivers, by Toni Bernhard (Wisdom, 2010).
THE POLITICS OF BIOETHICS, by Alan Petersen (Routledge, 2010).
"Complete and lasting freedom from disease is but a dream remembered from imaginings of a Garden of Eden."
-Rene Dubos
This electronic newsletter, edited by Harry (Rick) Moody, is published by HealthCare Chaplaincy and co-sponsored by the Office of Academic Affairs at AARP.
The opinions stated are those of Mr. Moody and may not necessarily reflect those of HealthCare Chaplaincy or AARP.
To submit items of interest, contact H.R. Moody at soulofbioethics@yahoo.com
(c) Copyright 2012; all rights reserved.
