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Publisher: Project MUSE   (Total: 294 journals)

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Showing 1 - 200 of 294 Journals sorted alphabetically
Ab Imperio     Full-text available via subscription   (Followers: 1, SJR: 0.405, h-index: 4)
Advertising & Society Review     Full-text available via subscription   (Followers: 14)
African Economic History     Full-text available via subscription   (Followers: 11)
Alabama Review     Full-text available via subscription  
American Annals of the Deaf     Full-text available via subscription   (Followers: 13, SJR: 0.404, h-index: 31)
American Book Review     Full-text available via subscription   (Followers: 8, SJR: 0.102, h-index: 1)
American Catholic Studies     Full-text available via subscription  
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Anthropologica     Full-text available via subscription   (Followers: 5, SJR: 0.172, h-index: 12)
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Archives of Asian Art     Full-text available via subscription   (Followers: 9, SJR: 0.101, h-index: 3)
Arizona J. of Hispanic Cultural Studies     Full-text available via subscription   (Followers: 3)
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ASEAN Economic Bulletin     Full-text available via subscription   (Followers: 5)
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Biography     Full-text available via subscription   (Followers: 17, SJR: 0.23, h-index: 14)
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Bulletin of Medieval Canon Law     Full-text available via subscription   (Followers: 3)
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Canadian Ethnic Studies     Full-text available via subscription   (Followers: 3)
Canadian J. of Information and Library Science     Full-text available via subscription   (Followers: 301, SJR: 0.197, h-index: 12)
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Canadian J. of Philosophy     Full-text available via subscription   (Followers: 20, SJR: 0.265, h-index: 14)
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China : An Intl. J.     Full-text available via subscription   (Followers: 19, SJR: 0.181, h-index: 7)
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Cinema J.     Full-text available via subscription   (Followers: 22)
Civil War History     Full-text available via subscription   (Followers: 19, SJR: 0.176, h-index: 10)
Colorado Review     Full-text available via subscription   (Followers: 1)
Comitatus : A J. of Medieval and Renaissance Studies     Full-text available via subscription   (Followers: 20)
Comparative Drama     Full-text available via subscription   (Followers: 4, SJR: 0.114, h-index: 5)
Comparative Technology Transfer and Society     Full-text available via subscription   (Followers: 3)
Conradiana     Full-text available via subscription   (Followers: 1, SJR: 0.101, h-index: 3)
Conservative Judaism     Full-text available via subscription   (Followers: 5)
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Contemporary Southeast Asia: A J. of Intl. and Strategic Affairs     Full-text available via subscription   (Followers: 22, SJR: 0.277, h-index: 4)
CR : The New Centennial Review     Full-text available via subscription   (Followers: 3, SJR: 0.15, h-index: 12)
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Cross-Currents : East Asian History and Culture Review     Full-text available via subscription   (Followers: 3)
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Cultural Critique     Full-text available via subscription   (Followers: 10, SJR: 0.124, h-index: 16)
Demokratizatsiya: The J. of Post-Soviet Democratization     Full-text available via subscription   (Followers: 8, SJR: 0.414, h-index: 15)
Diaspora: A J. of Transnational Studies     Full-text available via subscription   (Followers: 13)
Dickens Quarterly     Full-text available via subscription   (Followers: 1, SJR: 0.1, h-index: 4)
Dictionaries : J. of the Dictionary Society of North America     Full-text available via subscription  
Digital Philology : A J. of Medieval Cultures     Full-text available via subscription   (Followers: 5)
Discourse     Full-text available via subscription   (Followers: 9)
Dublin James Joyce J.     Full-text available via subscription   (Followers: 1)
Early American Literature     Full-text available via subscription   (Followers: 7, SJR: 0.139, h-index: 10)
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Education and Treatment of Children     Full-text available via subscription   (Followers: 4, SJR: 0.619, h-index: 25)
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Emily Dickinson J.     Full-text available via subscription   (Followers: 3, SJR: 0.111, h-index: 4)
English Literature in Transition 1880-1920     Full-text available via subscription   (Followers: 6, SJR: 0.131, h-index: 5)
ESC: English Studies in Canada     Full-text available via subscription   (Followers: 3, SJR: 0.101, h-index: 6)
ESQ: A J. of the American Renaissance     Full-text available via subscription   (Followers: 1, SJR: 0.157, h-index: 6)
Essays in Medieval Studies     Full-text available via subscription   (Followers: 20)
Eudora Welty Review     Full-text available via subscription  
Feminist Formations     Full-text available via subscription   (Followers: 5)
Film & History: An Interdisciplinary J. of Film and Television Studies     Full-text available via subscription   (Followers: 37, SJR: 0.1, h-index: 2)
Forum J.     Full-text available via subscription   (Followers: 1)
Fourth Genre: Explorations in Nonfiction     Full-text available via subscription   (Followers: 1, SJR: 0.1, h-index: 1)
Framework : The J. of Cinema and Media     Full-text available via subscription   (Followers: 21)
Franciscan Studies     Full-text available via subscription   (Followers: 6, SJR: 0.101, h-index: 1)
French Colonial History     Full-text available via subscription   (Followers: 24, SJR: 0.101, h-index: 3)
Future Anterior     Full-text available via subscription   (Followers: 1, SJR: 0.101, h-index: 2)
Future of Children     Full-text available via subscription   (Followers: 5, SJR: 1.68, h-index: 62)
George Herbert J.     Full-text available via subscription  
German Studies Review     Full-text available via subscription   (Followers: 27, SJR: 0.116, h-index: 9)
Ghana Studies     Full-text available via subscription   (Followers: 15)
Goethe Yearbook     Full-text available via subscription   (Followers: 7)
Harvard J. of Asiatic Studies     Full-text available via subscription   (Followers: 15)
Hebrew Studies     Full-text available via subscription   (Followers: 5, SJR: 0.13, h-index: 2)
Helios     Full-text available via subscription   (Followers: 2, SJR: 0.111, h-index: 8)
Hemingway Review     Full-text available via subscription   (Followers: 4)
Henry James Review     Full-text available via subscription   (Followers: 4, SJR: 0.178, h-index: 8)
High School J.     Full-text available via subscription   (Followers: 2)
Hispania     Full-text available via subscription   (Followers: 8, SJR: 0.258, h-index: 5)
Hispanic Review     Full-text available via subscription   (Followers: 13, SJR: 0.177, h-index: 5)
Hispanófila     Full-text available via subscription   (Followers: 3, SJR: 0.1, h-index: 3)
Histoire sociale/Social history     Full-text available via subscription   (Followers: 9, SJR: 0.115, h-index: 8)
Historically Speaking     Full-text available via subscription   (Followers: 4)
Hopscotch: A Cultural Review     Full-text available via subscription  
Human Biology     Full-text available via subscription   (Followers: 9, SJR: 0.562, h-index: 45)
Human Rights Quarterly     Full-text available via subscription   (Followers: 69, SJR: 0.428, h-index: 46)
Humanity : An Intl. J. of Human Rights, Humanitarianism, and Development     Full-text available via subscription   (Followers: 17)
Information & Culture : A J. of History     Full-text available via subscription   (Followers: 36)
Intertexts     Full-text available via subscription   (Followers: 8)
Islamic Africa     Full-text available via subscription   (Followers: 3)
J. for the Study of Radicalism     Full-text available via subscription   (Followers: 8, SJR: 0.137, h-index: 3)
J. of American Folklore     Full-text available via subscription   (Followers: 5, SJR: 0.198, h-index: 15)
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J. of Burma Studies     Full-text available via subscription   (Followers: 4, SJR: 0.175, h-index: 3)
J. of Canadian Studies/Revue d'études canadiennes     Full-text available via subscription   (Followers: 4, SJR: 0.175, h-index: 10)
J. of College Student Development     Full-text available via subscription   (Followers: 8, SJR: 0.615, h-index: 47)
J. of Colonialism and Colonial History     Full-text available via subscription   (Followers: 24)
J. of Democracy     Full-text available via subscription   (Followers: 49, SJR: 1.815, h-index: 56)
J. of Developing Areas     Full-text available via subscription   (Followers: 6)
J. of Dramatic Theory and Criticism     Full-text available via subscription   (Followers: 4)
J. of Early Christian Studies     Full-text available via subscription   (Followers: 20, SJR: 0.252, h-index: 15)
J. of Health Care for the Poor and Underserved     Full-text available via subscription   (Followers: 6, SJR: 0.569, h-index: 42)
J. of Higher Education, The     Full-text available via subscription   (Followers: 37, SJR: 1.189, h-index: 57)
J. of Individual Psychology     Full-text available via subscription   (Followers: 5)
J. of Japanese Studies     Full-text available via subscription   (Followers: 15, SJR: 0.182, h-index: 13)
J. of Jewish Identities     Full-text available via subscription   (Followers: 11)
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J. of Late Antiquity     Full-text available via subscription   (Followers: 6)
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J. of Policy History     Full-text available via subscription   (Followers: 15, SJR: 0.116, h-index: 2)
J. of Shi'a Islamic Studies     Full-text available via subscription   (Followers: 4, SJR: 0.119, h-index: 2)
J. of Slavic Linguistics     Full-text available via subscription   (Followers: 2)
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J. of the Civil War Era     Full-text available via subscription   (Followers: 9)
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J. of the Malaysian Branch of the Royal Asiatic Society     Full-text available via subscription   (Followers: 5)
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J19 : The J. of Nineteenth-Century Americanists     Full-text available via subscription   (Followers: 3)
James Joyce Quarterly     Full-text available via subscription   (Followers: 7, SJR: 0.1, h-index: 3)
Jeunesse: Young People, Texts, Cultures     Full-text available via subscription   (Followers: 2)
Joyce Studies Annual     Full-text available via subscription   (Followers: 2)
Kennedy Institute of Ethics J.     Full-text available via subscription   (Followers: 5, SJR: 0.473, h-index: 32)
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Kritika: Explorations in Russian and Eurasian History     Full-text available via subscription   (Followers: 12, SJR: 0.432, h-index: 16)
L'Esprit Créateur     Full-text available via subscription   (Followers: 3, SJR: 0.103, h-index: 5)
La corónica : A J. of Medieval Hispanic Languages, Literatures, and Cultures     Full-text available via subscription   (Followers: 4)
Language     Full-text available via subscription   (Followers: 26, SJR: 1.678, h-index: 54)
Late Imperial China     Full-text available via subscription   (Followers: 9, SJR: 0.104, h-index: 8)
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Le mouvement social     Full-text available via subscription   (Followers: 1, SJR: 0.125, h-index: 7)
Leviathan : A J. of Melville Studies     Full-text available via subscription   (Followers: 2, SJR: 0.1, h-index: 2)
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Logos: A J. of Catholic Thought and Culture     Full-text available via subscription   (Followers: 15, SJR: 0.102, h-index: 4)
Magic, Ritual, and Witchcraft     Full-text available via subscription   (Followers: 10)
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Perspectives in Biology and Medicine     Full-text available via subscription   (Followers: 6, SJR: 0.295, h-index: 38)
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Journal Cover Perspectives in Biology and Medicine
  [SJR: 0.295]   [H-I: 38]   [6 followers]  Follow
    
   Full-text available via subscription Subscription journal
   ISSN (Print) 0031-5982 - ISSN (Online) 1529-8795
   Published by Project MUSE Homepage  [294 journals]
  • Introduction to the Special Issue
    • Abstract: In the summer of 2017, much of the world was riveted by the case of Charlie Gard, a baby in London whose parents wanted an experimental treatment and whose doctors thought that further treatment would be futile. The case worked its way through the British courts and, eventually, was even heard by the European Court of Human Rights. Pope Francis and President Trump weighed in. If nothing else, the case revealed how controversial the issues around medical futility and shared decision-making still are. Many ethical issues resolve over time. Discussions about disagreements lead to discovery of common ground. That doesn’t seem to be the case with the issue of medical futility and, particularly, with ... Read More
      Keywords: Critical care medicine; Medicine; Physician and patient; Terminal care; Advance directives (Medical care); French language; Brain death; Pediatric intensive care; Medical care; Euthanasia; Contraception; Abortion; Neonatal intensive care
      PubDate: 2018-01-31T00:00:00-05:00
       
  • The Abuse of Futility
    • Abstract: Two recent policy statements by providers of critical care representing the United States and Europe have rejected the concept and language of “medical futility,” on the ground that there is no universal consensus on a definition. They recommend using “potentially inappropriate” or “inappropriate” instead (Bosslet et al. 2015; Nates et al. 2016). As Bosslet and colleagues state: The term “potentially inappropriate” should be used, rather than futile, to describe treatments that have at least some chance of accomplishing the effect sought by the patient, but clinicians believe that competing ethical considerations justify not providing them. Clinicians should explain and advocate for the treatment plan ... Read More
      Keywords: Critical care medicine; Medicine; Physician and patient; Terminal care; Advance directives (Medical care); French language; Brain death; Pediatric intensive care; Medical care; Euthanasia; Contraception; Abortion; Neonatal intensive care
      PubDate: 2018-01-31T00:00:00-05:00
       
  • Resolving Family-Clinician Disputes in the Context of Contested
           Definitions of Futility
    • Abstract: We appreciate the opportunity to respond to Schneiderman and colleagues’ (2017) opinions on the recent Multiorganization Policy Statement, “An Official ATS/AACN/ACCP/ESICM/SCCM Policy Statement: Responding to Requests for Potentially Inappropriate Treatments in Intensive Care Units” (Bosslet et al. 2015). We will first point out three areas in which Schneiderman and colleagues seem to perceive a disagreement where there is none, then we will respond to their main criticisms of the Multiorganization Policy Statement. In doing so, we will point out areas in which we believe Schneiderman and colleagues have either misunderstood or misrepresented the statement. First, we agree with Schneiderman and ... Read More
      Keywords: Critical care medicine; Medicine; Physician and patient; Terminal care; Advance directives (Medical care); French language; Brain death; Pediatric intensive care; Medical care; Euthanasia; Contraception; Abortion; Neonatal intensive care
      PubDate: 2018-01-31T00:00:00-05:00
       
  • Getting Past Words: Futility and the Professional Ethics of
           Life-Sustaining Treatment
    • Abstract: In this issue of Perspectives in Biology and Medicine, Schneiderman and colleagues critique a recent multi-society policy statement—developed by the American Thoracic Society (ATS) and endorsed by four other organizations—entitled “Responding to Requests for Potentially Inappropriate Treatment in Intensive Care Units” (Bosslet et al. 2015). The focus of Schneiderman’s critique is the Multiorganization Policy Statement’s choice of the term “potentially inappropriate” to describe a class of interventions that clinicians should resist providing (or decline to provide) for patients near the end of life, even when patients or their families request or demand them.1 Schneiderman and colleagues argue that the term ... Read More
      Keywords: Critical care medicine; Medicine; Physician and patient; Terminal care; Advance directives (Medical care); French language; Brain death; Pediatric intensive care; Medical care; Euthanasia; Contraception; Abortion; Neonatal intensive care
      PubDate: 2018-01-31T00:00:00-05:00
       
  • Futility: Definition and Goals
    • Abstract: A recent statement from multiple critical care societies (Bosslet et al. 2015) appropriately focuses on communication and negotiation as the major approach to the sorts of cases that have previously been labeled with the term futility. Unfortunately, the statement persists in addressing futility in a way that I have argued is unsatisfactory (Brody 1997). Schneiderman, Jecker, and Jonsen (2017) now respond to the statement and make a number of helpful points. However, in a few ways, I also find their response off target. I will address the key points of the discussion in a way that is consistent with a position I took some years ago and that I still believe to be appropriate (Brody 1997, 1998). I ... Read More
      Keywords: Critical care medicine; Medicine; Physician and patient; Terminal care; Advance directives (Medical care); French language; Brain death; Pediatric intensive care; Medical care; Euthanasia; Contraception; Abortion; Neonatal intensive care
      PubDate: 2018-01-31T00:00:00-05:00
       
  • Futile Treatment and Conquering Death
    • Abstract: Not long ago I was called by my brother’s doctor. He wanted to know if I would accept his judgment that the respirator for my brother should be turned off. Vince, age 81, had contracted West Nile virus, normally treated successfully in 99% of cases, but often lethal in 1%. My brother was in that 1%, with a fast onset of the disease and a no less rapid decline into a coma, all in one day. There was no pain or suffering. His doctor called me one month later for my decision. I had no hesitation in agreeing with him—despite knowing that some patients do come out of seemingly irreversible comas later, even much later, than that—a low probability, but not a certainty. But my brother had lived a long and ... Read More
      Keywords: Critical care medicine; Medicine; Physician and patient; Terminal care; Advance directives (Medical care); French language; Brain death; Pediatric intensive care; Medical care; Euthanasia; Contraception; Abortion; Neonatal intensive care
      PubDate: 2018-01-31T00:00:00-05:00
       
  • Who Will Teach Us to Die': Reflections on Futility and Finitude
    • Abstract: Schneiderman, Jecker, and Jonsen (2017) have written an eloquent essay that both defends the concept of medical futility and describes (again) their own candidate for a practical, working definition. Whether they have provided the best such definition I cannot say, but they are surely right to claim that some such concept is needed—for doctors to practice, for patients to receive good care, for family and friends of the patient to understand and prepare for what is happening, and for society to trust what doctors say and do in delivering care. In brief, futility—or something like it—is a concept with important personal and social value, and more than simple prognostic meaning. One of the ... Read More
      Keywords: Critical care medicine; Medicine; Physician and patient; Terminal care; Advance directives (Medical care); French language; Brain death; Pediatric intensive care; Medical care; Euthanasia; Contraception; Abortion; Neonatal intensive care
      PubDate: 2018-01-31T00:00:00-05:00
       
  • The Brutal but Utile Truth of “Futile”
    • Abstract: What term is most appropriate in describing the limits of medicine' That depends on who determines the limits and the bases on which those limits are delineated and communicated. Schneiderman, Jecker, and Jonsen (2017) critique two recent policy statements by critical care providers—Bosslet et al. (2015) and Nates et al. (2016)—for their rejection of the use of the term futile for treatment. Both statements recommend using the adjective inappropriate for the problematic treatment, rather than futile, based on the lack of consensus of just what constitutes futility. Schneiderman, Jecker, and Jonsen also assert that, despite a lack of consensus about the determination of futility, the definitions they have ... Read More
      Keywords: Critical care medicine; Medicine; Physician and patient; Terminal care; Advance directives (Medical care); French language; Brain death; Pediatric intensive care; Medical care; Euthanasia; Contraception; Abortion; Neonatal intensive care
      PubDate: 2018-01-31T00:00:00-05:00
       
  • Futility, Inappropriateness, Conflict, and the Complexity of Medical
           Decision-Making
    • Abstract: . . . and the baby has a large VSD. Otherwise appears well, gaining weight, smiling. No apnea, never been on ventilator. Local cardiac surgeon refused to operate, saying that surgery would be inappropriate. Have reached out to other centers, and some state that they never perform what they said was “futile” heart surgery on children with Trisomy 18, while other sites say they have and will continue to perform these operations. Can someone explain to me what is going on' In the realm of medical care—given enough patients, clinicians, and time—conflict is inevitable. Someone will want to do something, such as give a drug or start a new form of technologic support, and someone else will think that this is a ... Read More
      Keywords: Critical care medicine; Medicine; Physician and patient; Terminal care; Advance directives (Medical care); French language; Brain death; Pediatric intensive care; Medical care; Euthanasia; Contraception; Abortion; Neonatal intensive care
      PubDate: 2018-01-31T00:00:00-05:00
       
  • Futility, the Multiorganization Policy Statement, and the Schneiderman
           Response
    • Abstract: “Futility of futilities,” said Kohelet, “futility of futilities, all is futile!” Once again we are exploring futility, a concept understood by humanity at least from the beginning of the written word. Our oldest written story, the Epic of Gilgamesh, reminds us of the futility of chasing immortality. At least a millennium later, yet still in ancient times, the Book of Kohelet (Ecclesiastes) teaches that all human pursuits, not only the pursuit of immortality, are futile or vain—terms once used synonymously. The ancient Greeks introduced an element of punishment into their stories of futility—for example the Danaides sisters were condemned for the murder of their betrothed to use small urns to fill a leaky ... Read More
      Keywords: Critical care medicine; Medicine; Physician and patient; Terminal care; Advance directives (Medical care); French language; Brain death; Pediatric intensive care; Medical care; Euthanasia; Contraception; Abortion; Neonatal intensive care
      PubDate: 2018-01-31T00:00:00-05:00
       
  • “Futility” as in English or “Futilities” as in French: A Valuable
           Semantic Misunderstanding'
    • Abstract: In the French language, it sounds very odd indeed to associate the word futility with serious things, and especially with medicine. The term is most often used to speak of “frivolities,” such as trinkets or any other bling-bling. “On parle à Paris et on ne pense guère, la journée se passe en futilités” (“In Paris, one chats, one hardly thinks, days are filled in futilities”), Voltaire wrote in a 1765 letter (Voltaire 1982); or “De cette indigne classe où nous rangent les hommes, de borner nos talents à des futilités” (“From this unworthy class in which men put us, limiting our talents to only futilities”), said Molière in his 1672 play, Les Femmes savantes (The Learned Ladies). It looks as though the term ... Read More
      Keywords: Critical care medicine; Medicine; Physician and patient; Terminal care; Advance directives (Medical care); French language; Brain death; Pediatric intensive care; Medical care; Euthanasia; Contraception; Abortion; Neonatal intensive care
      PubDate: 2018-01-31T00:00:00-05:00
       
  • Mediative Fluency and Futility Disputes
    • Abstract: It is generally agreed that physicians should not provide futile interventions, for the obvious reason that an intervention without utility causes harm without benefit. However, despite efforts to standardize a definition, there is a lack of universal consensus as to what constitutes “futility.” Two recent policy statements object to the terminology of futility based on the lack of a universal definition (Bosslet et al. 2015; Nates et al. 2016). Schneiderman, Jecker, and Jonsen (2017) object to the proposed alternative terminology of “inappropriate.” These differing opinions about the most apt terminology raise the question of whether definitions are helpful or counterproductive in addressing disputes that ... Read More
      Keywords: Critical care medicine; Medicine; Physician and patient; Terminal care; Advance directives (Medical care); French language; Brain death; Pediatric intensive care; Medical care; Euthanasia; Contraception; Abortion; Neonatal intensive care
      PubDate: 2018-01-31T00:00:00-05:00
       
  • Futile and Potentially Inappropriate Interventions: Semantics Matter
    • Abstract: Recently, five major critical care professional organizations in North America and Europe published a consensus policy statement on how intensive care unit (ICU) clinicians should respond to patient or surrogate requests for potentially inappropriate treatments (Bosslet et al. 2015). Subsequently, the Society for Critical Care Medicine (SCCM), the largest multidisciplinary critical care organization and one of the authors of the Multiorganization Policy Statement, issued a companion statement defining futile and potentially inappropriate interventions (Kon et al. 2016a). These statements support previous work published by the SCCM Ethics Committee 20 years ago (Danis et al. 1997). The critical care ... Read More
      Keywords: Critical care medicine; Medicine; Physician and patient; Terminal care; Advance directives (Medical care); French language; Brain death; Pediatric intensive care; Medical care; Euthanasia; Contraception; Abortion; Neonatal intensive care
      PubDate: 2018-01-31T00:00:00-05:00
       
  • Intractable Disagreements About Futility
    • Abstract: It used to be futile to try to save babies born at 23 weeks. It isn’t anymore. It used to be futile to try to keep patients with end-stage congestive heart failure alive. It isn’t anymore. Futility is a moving target. Thus, it is not surprising that doctors, patients, and families often disagree about which treatments are efficacious or futile, appropriate or inappropriate, obligatory or obligatorily withheld. The goalposts keep moving. Yesterday’s impossibility is today’s routine. Why should a patient believe a doctor who says that treatment is futile, inappropriate, or likely to cause more harm than good' Could it just mean that the doctors are unwilling to try everything that is available' When ... Read More
      Keywords: Critical care medicine; Medicine; Physician and patient; Terminal care; Advance directives (Medical care); French language; Brain death; Pediatric intensive care; Medical care; Euthanasia; Contraception; Abortion; Neonatal intensive care
      PubDate: 2018-01-31T00:00:00-05:00
       
  • Medical Futility and “Brain Death”
    • Abstract: I’m writing to underscore one point, which should be obvious, but which all too often has been neglected in the literature on medical futility. The futility of an action or an intervention is always relative to some goal. Consider the classical example of futility: carrying water in a sieve. If your goal is to transport a quantity of water without spilling some or all of it, then it is futile to do so by placing it in a sieve. But we can readily imagine children carrying water in the backyard in a sieve, enjoying the water spilling out on the grass and trickling down their legs. It’s not futile to serve that goal of having fun. The salience of this point can be tested by examining its relevance to ... Read More
      Keywords: Critical care medicine; Medicine; Physician and patient; Terminal care; Advance directives (Medical care); French language; Brain death; Pediatric intensive care; Medical care; Euthanasia; Contraception; Abortion; Neonatal intensive care
      PubDate: 2018-01-31T00:00:00-05:00
       
  • The True Abuse of Futility
    • Abstract: Futility has indeed been abused. The term has been applied and misapplied, defined and redefined, molded and remolded until the real meaning is no longer understood. When a word loses its meaning, it loses its power. The reason that the term is no longer clear is because attempts have been made to include scenarios under the banner of futility that do not truly fit. From my perspective as a pediatric critical care physician, the majority of troublesome cases are not questions of true futility. More frequently, the ethical concerns and moral distress encountered in the pediatric intensive care unit are not in the realm of the unambiguous; it is precisely in the ambiguous where distress is felt and ... Read More
      Keywords: Critical care medicine; Medicine; Physician and patient; Terminal care; Advance directives (Medical care); French language; Brain death; Pediatric intensive care; Medical care; Euthanasia; Contraception; Abortion; Neonatal intensive care
      PubDate: 2018-01-31T00:00:00-05:00
       
  • Criterialism versus Deliberativism
    • Abstract: I was one of the group that produced “An Official ATS/AACN/ACCP/ESICM/SCCM Policy Statement: Responding to Requests for Futile and Potentially Inappropriate Treatments in Intensive Care Units” (Bosslet et al. 2015). I do not write on that group’s behalf, but rather from two distinct perspectives which converge onto one view. First, I am a philosopher who thinks about our most pressing questions, such as how to make treatment decisions when a life is coming to an end. From that perspective, three of us from the group tried to set out the philosophical position that seemed to underpin the Multiorganization Policy Statement (Misak, White, and Truog 2016). That deliberativist position holds that ... Read More
      Keywords: Critical care medicine; Medicine; Physician and patient; Terminal care; Advance directives (Medical care); French language; Brain death; Pediatric intensive care; Medical care; Euthanasia; Contraception; Abortion; Neonatal intensive care
      PubDate: 2018-01-31T00:00:00-05:00
       
  • Medical Futility and Involuntary Passive Euthanasia
    • Abstract: Conflicts surrounding the provision of life-sustaining treatment create difficult ethical and interpersonal challenges for providers, patients, and families or other surrogates alike. These conflicts implicate a constellation of ethical concepts, including distributive justice, harms and wrongs to patients, fiduciary obligations to patients, standards for surrogate decision-making, and medical futility. Recently, several critical care societies published a policy statement on conflicts at the end of life, and advocated for a new concept, “potentially inappropriate treatment” (Bosslet et al. 2015). They argued that in some circumstances, after due process, physicians and hospitals should have the authority to ... Read More
      Keywords: Critical care medicine; Medicine; Physician and patient; Terminal care; Advance directives (Medical care); French language; Brain death; Pediatric intensive care; Medical care; Euthanasia; Contraception; Abortion; Neonatal intensive care
      PubDate: 2018-01-31T00:00:00-05:00
       
  • Medical Futility and Potentially Inappropriate Treatment: Better Ethics
           with More Precise Definitions and Language
    • Abstract: Like the authors of some of the other responses to Schneiderman, Jecker, and Jonsen (2017), I too was one of the group that produced “An Official ATS/AACN/ACCP/ESICM/SCCM Policy Statement: Responding to Requests for Futile and Potentially Inappropriate Treatments in Intensive Care Units” (Bosslet et al. 2015). Furthermore, ethical and legal issues surrounding futile and potentially inappropriate medical treatment have been a primary focus of my scholarship for more than a decade (Pope 2017a). Schneiderman, Jecker, and Jonsen offer a strong critique of the Multiorganization Statement, but they do not describe it with sufficient precision. There are points of true normative disagreement between the ... Read More
      Keywords: Critical care medicine; Medicine; Physician and patient; Terminal care; Advance directives (Medical care); French language; Brain death; Pediatric intensive care; Medical care; Euthanasia; Contraception; Abortion; Neonatal intensive care
      PubDate: 2018-01-31T00:00:00-05:00
       
  • The Concept of Futility: Recognizing the Importance of Context
    • Abstract: As a member of the committee that authored the Multiorganization Policy Statement under discussion (Bosslet et al. 2015), I fully endorse the response of Bosslet and my colleagues to the provocative article by Schneiderman, Jecker, and Jonson (2017). In addition, I would like to offer some thoughts about how the different positions reflected here may be at least partially reconciled by considering the different contexts in which the word and the concept of futility may be invoked. The main thrust of the classic paper by Schneiderman, Jecker, and Jonsen (1990), which is that medicine should not offer or perform treatments that are futile, still resonates with many clinicians, including myself. I ... Read More
      Keywords: Critical care medicine; Medicine; Physician and patient; Terminal care; Advance directives (Medical care); French language; Brain death; Pediatric intensive care; Medical care; Euthanasia; Contraception; Abortion; Neonatal intensive care
      PubDate: 2018-01-31T00:00:00-05:00
       
  • End-of-Life Futility Conversations: When Language Matters
    • Abstract: Caring for seriously ill patients and their families during times of extreme stress is a privilege, but it can also bring much sadness and ethical turmoil for everyone involved, particularly at end of life. Patients and their families and the nurses and physicians who care for them are uniquely bonded together as they discuss, discern, and deliberate on some of the most heart-wrenching life and death decisions any patient, parent, family member, or partner can make. Shifting from a curative mode of thinking is never easy, simple, or clear-cut. All of us share hopeful moments with our patients when we see, for example, an unexpected limb movement, a period of lucidity, or short-term physiological stability in ... Read More
      Keywords: Critical care medicine; Medicine; Physician and patient; Terminal care; Advance directives (Medical care); French language; Brain death; Pediatric intensive care; Medical care; Euthanasia; Contraception; Abortion; Neonatal intensive care
      PubDate: 2018-01-31T00:00:00-05:00
       
  • Why Some “Futile” Care Is “Appropriate”: The Implications for
           Conscientious Objection to Contraceptive Services
    • Abstract: Schneiderman, Jecker, and Jonsen (2017) disagree with two recent policy statements of professional medical organizations (Bosslet et al. 2015; Nates et al. 2016) over whether to call some medical interventions “inappropriate” or “potentially inappropriate” that have previously been labelled “futile.” I would agree that inappropriate is a hopelessly ambiguous term that should not be used in the long-running debate, more normally referred to as the futility controversy. I find, however, that Schneiderman, Jecker, and Jonsen end up with the same policy conclusion as the two policy statements. When patients or their surrogates disagree with clinicians about whether to provide certain treatments, they all ... Read More
      Keywords: Critical care medicine; Medicine; Physician and patient; Terminal care; Advance directives (Medical care); French language; Brain death; Pediatric intensive care; Medical care; Euthanasia; Contraception; Abortion; Neonatal intensive care
      PubDate: 2018-01-31T00:00:00-05:00
       
  • Nurturing Futility in the NICU: The Dutch Perspective
    • Abstract: In 2015, the ATS/AACN/ACCP/ESICM/SCCM published an official policy statement about responding to requests for potentially inappropriate treatments in intensive care units (Bosslet et al. 2015). The Multiorganization Statement aims to provide guidance for clinicians to prevent and manage disputes about patients with advanced critical illness. Recommendations 2 and 3 focus on terminology and suggest an alternative set of words to define and to help manage medical futility. Recommendations 1 and 4 focus on conflict resolution strategies and the development of new policies or legislation about when life-prolonging technologies should not be used. Schneiderman and colleagues (2017) have written an ... Read More
      Keywords: Critical care medicine; Medicine; Physician and patient; Terminal care; Advance directives (Medical care); French language; Brain death; Pediatric intensive care; Medical care; Euthanasia; Contraception; Abortion; Neonatal intensive care
      PubDate: 2018-01-31T00:00:00-05:00
       
 
 
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