• Ethical Issues: A Good Death 

    Fleming, David A. (Center for Health Ethics, 2006-03)
    For elderly patients, especially those in long term facilities, the risk of death is obviously high. The challenge, therefore, as health care providers is knowing when to employ our healing powers to enable a “good death” ...
  • Ethical Issues: Access in Missouri 

    Fleming, David A. (Center for Health Ethics, 2007-06)
    Medicaid spending in Missouri has been growing at double-digit rates since 1998, expanding to cover almost one in five citizens and contributing to the state's growing budgetary problems. Medicaid expenditures increased ...
  • Ethical Issues: Assisted Suicide Upheld 

    Fleming, David A. (Center for Health Ethics, 2006-01)
    The ethical controversy invited by legally allowing physician assisted suicide is a familiar and complex one in which personal rights, states' rights, professional obligation, and the federal government's sense of global ...
  • Ethical Issues: Caring for the Caregiver 

    Fleming, David A. (Center for Health Ethics, 2004-03)
    One of the important details we tend to overlook when taking care of patients with debilitating or life-threatening disease is the welfare of those family members taking care of the patient at home. The burden of providing ...
  • Ethical Issues: Communication 

    Fleming, David A. (Center for Health Ethics, 2004-05)
    Nothing is more important to the welfare of patients, providers, and health care systems than effective patient centered communication. This occurs by having the knowledge, attitudes, skills, and organizational infrastructure ...
  • Ethical Issues: Communication and Prevention 

    Fleming, David A. (Center for Health Ethics, 2005-05)
    Health illiteracy is a serious and growing problem in this country. According to the Institute of Medicine (IOM) nearly half of all American adults (that's 90 million people) have difficulty understanding and using health ...
  • Ethical Issues: Disparities in End of Life Care 

    Fleming, David A. (Center for Health Ethics, 2004-09)
    Market strategies tend to work as a negative force when it comes to ensuring adequate health care for the underserved in our society. When it comes to health care, and in particular end of life care, color still divides.
  • Ethical Issues: DNR Revisited 

    Fleming, David A. (Center for Health Ethics, 2005-02)
    In most cultures, when making treatment decisions for adults, children, and neonates with end stage illness, there tends to be universal agreement that overly aggressive treatment should be discouraged when death is near ...
  • Ethical Issues: Engaging Patients 

    Fleming, David A. (Center for Health Ethics, 2004-11)
    The Institute for Ethics at the American Medical Association initiated the Ethical Force Program in 1997. The purpose of E Force is to develop performance measures for ethical behavior and practices that can be useful ...
  • Ethical Issues: Ethical Research 

    Fleming, David A. (Center for Health Ethics, 2004-12)
    In academic medicine we are ruled by many masters—the need to see patients, the expectations of teaching, the desire (and expectation) to advance our careers through scholarship and research, and the ever present specter ...
  • Ethical Issues: Ethics Consultation 

    Fleming, David A. (Center for Health Ethics, 2003-09)
    Making decisions within the complexities of modern health care is not easy. This is especially true in a training environment. Ethical dilemmas often present themselves, and having a mechanism available to effectively ...
  • Ethical Issues: Futility Policies 

    Fleming, David A. (Center for Health Ethics, 2005-03)
    Futility, in general, is the inability to achieve an intended goal or outcome. Biomedical futility more specifically is a clinical judgment that, in light of the patient's current clinical circumstance, it is not physiologically ...
  • Ethical Issues: Futility Policies and Politics 

    Fleming, David A. (Center for Health Ethics, 2006-10)
    In Texas Legislators are having second thoughts about a controversial futile care law that allows hospitals to unilaterally terminate life support in patients with end stage illness. Under the terms of the state's "futile-care ...
  • Ethical Issues: Malpractice Crisis 

    Fleming, David A. (Center for Health Ethics, 2004-04)
    Medicine is in crisis. Doctors, especially those in high-risk specialties like obstetrics and neurosurgery, are leaving their practices in response to ballooning malpractice costs. Malpractice rates for physicians are ...
  • Ethical Issues: Narrowing the Disparity Gap 

    Fleming, David A. (Center for Health Ethics, 2005-11)
    In 2003 the Institute of Medicine, in Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care, reported a consistent body of research demonstrating significant racial variation in the access to and ...
  • Ethical Issues: Organ Donation and Procurement 

    Fleming, David A. (Center for Health Ethics, 2005-01)
    The list of people waiting for organ transplants continues to grow. According to the Missouri Hospital Association more than 80,000 men, women and children nationwide are waiting for new organs, including more than 1,800 ...
  • Ethical Issues: Patient-Centered Communication 

    Fleming, David A. (Center for Health Ethics, 2006-06)
    A newly released consensus report by the American Medical Association's Ethical Force Program “Improving Communication—Improving Care” helps health care executives prioritize effective, patient-centered communication and ...
  • Ethical Issues: Recommendations of the Citizens' Health Care Working Group 

    Fleming, David A. (Center for Health Ethics, 2006-11)
    There is an important update regarding legislative attempts to improve health care, including end of life care, for all Americans in the this week's Update of the Missouri Hospice & Palliative Care Association (MHPCA). In ...
  • Ethical Issues: Reflections on HB 905 

    Fleming, David A. (Center for Health Ethics, 2005-04)
    In times of crisis there are opportunities to grow and learn. With the suffering and demise of Terri Shiavo patients, families, and health care providers again find themselves in doubt as to what to do in the midst of very ...
  • Ethical Issues: Saying I'm Sorry 

    Fleming, David A. (Center for Health Ethics, 2005-06)
    Patients respond more favorably and are more trusting of physicians who provide full disclosure about medical errors than physicians who are less forthright or purposely hold things back when things go wrong. But there is ...