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Wish to die trying to live: unwise or incapacitous? The case of University Hospitals Birmingham NHS Foundation Trust versus 'ST'.
J Med Ethics
November 2024
Department of Health Humanities and Bioethics, University of Rochester, Rochester, New York, USA.
The recent legal dispute about medical treatment for a 19-year-old patient, Sudiksha Thirumalesh, (known initially by the Court of Protection as 'ST') in A NHS Trust versus ST & Ors (2023) raised several challenging ethical issues. While Sudiksha's case bears similarities to other high-profile cases in England and Wales, there are key differences. Crucially, Sudiksha herself was part of the disagreement.
View Article and Find Full Text PDFFlexibility and Innovation in Decisional Capacity Assessment.
J Am Acad Psychiatry Law
December 2024
Dr. Appel is a Professor of Psychiatry and Medical Education and Associate Director, Academy for Medicine & the Humanities, Icahn School of Medicine at Mount Sinai, New York, NY.
Since the 1980s, the four skills criteria have become the most widely accepted mechanism for the assessment of decisional capacity in the United States. These criteria emerged in response to the paternalistic approach to clinical decision-making that had been widely accepted in an earlier era and offered a means of ensuring that physicians honored the rights of capacitated patients to make their own medical decisions. Unfortunately, the criteria are now applied to situations for which they are not suited and in a manner that is often highly inflexible.
View Article and Find Full Text PDFThe Need for Culturally Tailored CKD Education in Older Latino Patients and Their Families.
Am J Kidney Dis
February 2025
Research on Ethics, Aging, and Community Health (REACH Lab), Tufts University, Medford, Massachusetts; Department of Community Health, Tufts University, Medford, Massachusetts.
Older Latino adults (aged 65+years) comprise the fastest growing minoritized group among the older population in the United States and experience a disproportionate burden of kidney failure as well as disparities in kidney care compared with non-Hispanic White individuals. Despite significant need and barriers uniquely faced by this population, few educational resources or decision aids are available to meet the language and cultural needs of Latino patients. Decision aids are designed to improve knowledge and empower individuals to engage in shared decision making and have been shown to improve decisional quality and goal-concordant care among older patients with chronic kidney disease (CKD).
View Article and Find Full Text PDFMobile Mindfulness Intervention for Psychological Distress Among Intensive Care Unit Survivors: A Randomized Clinical Trial.
JAMA Intern Med
July 2024
Department of Medicine, Oregon Health & Science University, Portland.
Article Synopsis
- Psychological distress is common among survivors of critical illness, but effective therapies are limited, prompting the need for a tailored mindfulness intervention.
- This randomized clinical trial aimed to find the best way to deliver mindfulness meditation through a mobile app, evaluating components like introduction method, meditation frequency, and symptom management.
- Results showed that participants who practiced meditation twice daily had significantly lower depression scores compared to those who practiced once daily, while adherence to the intervention was high among participants.
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