Improving Advance Directives with Video
In the opening scene of Annie Hall, the film’s main character tells a joke about two elderly women who are lamenting the decline of a restaurant. The first woman says “‘Boy, the food at this place is really terrible.’ The other one says, ‘Yeah, I know. And such small portions.’” If you’ll permit a health ethics joke, a similar lament applies to advance directives: They’re unhelpful and too few people have them.
This insight article describes some of the shortcomings of written advance directives and explains how making videos to accompany the legal document can help ensure patients receive the care they want.
Four Steps to Patient-Centred Care: Moving Beyond the Buzzword
Patient-centred care is about providing care that aligns with the patient’s values: i.e., it’s care the patient actually wants and will benefit from. Despite the popularity of this concept, studies show that there’s a long way to go before it’s ubiquitous. In this post, we describe a four-step framework for implementing patient-centred care.
Why Your Hospital Needs Access to a Clinical Ethicist
There is overwhelming evidence that clinical ethicists provide tremendous value for patients, care teams, and hospitals. Where once clinical ethicists were only available at research and training hospitals, now, almost every hospital in the U.S. with more than 400 beds has one. This is because professional ethicists—especially those with advanced degrees in ethics and fellowship training—have consistently demonstrated the value of having access to experts in ethics advising.
Types of Clinical Ethics Consultations
Clinical ethics consultations can take many forms, and there’s no pathway they all must take. Instead, the ethicist, in consultation with the care team, will determine what level of involvement is most appropriate for the ethicist. In this article, I describe three levels of consultation and give some examples of each.
How Technology Causes Physician Burnout
The promise of clinical information systems (CIS), including electronic health records (EHRs) and other digital solutions, included fewer mistakes than hand-written notes, better continuity of care from access to patient records in different settings, and more efficient record keeping so that providers would have more time with patients. It hasn’t worked out this way.
Death by Neurological Criteria: Really, Most Sincerely Death
Brain death is just death. It is confusing and unhelpful to refer to someone as brain dead, and just as the term ‘heart dead’ isn’t capturing a useful distinction, neither is ‘brain dead’. As the authors in a Neurology article put it, following The Wizard of Oz, when someone is brain dead they are “really, most sincerely dead.”