34 found
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  1.  89
    (1 other version)Medical futility: its meaning and ethical implications.Lawrence J. Schneiderman, Nancy S. Jecker & Albert R. Jonsen - forthcoming - Bioethics.
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  2. Defining Medical Futility and Improving Medical Care.Lawrence J. Schneiderman - 2011 - Journal of Bioethical Inquiry 8 (2):123-131.
    It probably should not be surprising, in this time of soaring medical costs and proliferating technology, that an intense debate has arisen over the concept of medical futility. Should doctors be doing all the things they are doing? In particular, should they be attempting treatments that have little likelihood of achieving the goals of medicine? What are the goals of medicine? Can we agree when medical treatment fails to achieve such goals? What should the physician do and not do under (...)
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  3.  94
    Rationing Just Medical Care.Lawrence J. Schneiderman - 2011 - American Journal of Bioethics 11 (7):7-14.
    U.S. politicians and policymakers have been preoccupied with how to pay for health care. Hardly any thought has been given to what should be paid for—as though health care is a commodity that needs no examination—or what health outcomes should receive priority in a just society, i.e., rationing. I present a rationing proposal, consistent with U.S. culture and traditions, that deals not with “health care,” the terminology used in the current debate, but with the more modest and limited topic of (...)
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  4. Medical Futility: The Duty Not to Treat.Nancy S. Jecker & Lawrence J. Schneiderman - 1993 - Cambridge Quarterly of Healthcare Ethics 2 (2):151.
    Partly because physicians can “never say never,” partly because of the seduction of modern technology, and partly out of misplaced fear of litigation, physicians have increasingly shown a tendency to undertake treatments that have no realistic expectation of success. For this reason, we have articulated common sense criteria for medical futility. If a treatment can be shown not to have worked in the last 100 cases, we propose that it be regarded as medically futile. Also, if the treatment fails to (...)
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  5. Response to Open Peer Commentaries on “Irrational Exuberance: Cardiopulmonary Resuscitation as Fetish”.Philip M. Rosoff & Lawrence J. Schneiderman - 2017 - American Journal of Bioethics 17 (2):W1 - W3.
    The Institute of Medicine and the American Heart Association have issued a “call to action” to expand the performance of cardiopulmonary resuscitation in response to out-of-hospital cardiac arrest. Widespread advertising campaigns have been created to encourage more members of the lay public to undergo training in the technique of closed-chest compression-only CPR, based upon extolling the virtues of rapid initiation of resuscitation, untempered by information about the often distressing outcomes, and hailing the “improved” results when nonprofessional bystanders are involved. We (...)
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  6. Alternative Medicine or Alternatives to Medicine? A Physician's Perspective.Lawrence J. Schneiderman - 2000 - Cambridge Quarterly of Healthcare Ethics 9 (1):83-97.
    Regina R. is a 12-year-old girl with recently diagnosed insulin-dependent diabetes. Before discharging her from the hospital, her family physician and consulting diabetes specialist try to instruct the girl and her parents in the appropriate program of treatment, including diet, insulin, and regular self-monitoring. However, the parents become upset when they learn what is involved in insulin treatment and inform the family physician they plan to employ the services of an alternative healing clinic that promises to cure their daughter with (...)
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  7. Commentary: Bringing Clarity to the Futility Debate: Are the Cases Wrong? Lawrence J. Schneiderman.Lawrence J. Schneiderman - 1998 - Cambridge Quarterly of Healthcare Ethics 7 (3):273-278.
    Howard Brody expresses concern that citing the “two cases that put futility on the map,” namely Helga Wanglie and Baby K, may be providing ammunition to the opponents of the concept of medical futility. He in fact joins well-known opponents of the concept of medical futility in arguing that it is one thing for the physician to say whether a particular intervention will promote an identified goal, quite another to say whether a goal is worth pursuing. In the latter instance, (...)
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  8.  79
    Should a criminal receive a heart transplant? Medical justice vs. societal justice.Lawrence J. Schneiderman & Nancy S. Jecker - 1996 - Theoretical Medicine and Bioethics 17 (1).
    Should the nation provide expensive care and scarce organs to convicted felons? We distinguish between two fields of justice: Medical Justice and Societal Justice. Although there is general acceptance within the medical profession that physicians may distribute limited treatments based solely on potential medical benefits without regard to nonmedical factors, that does not mean that society cannot impose limits based on societal factors. If a society considers the convicted felon to be a full member, then that person would be entitled (...)
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  9.  44
    Proactive Ethics Consultation in the ICU: A Comparison of Value Perceived by Healthcare Professionals and Recipients.Felicia Cohn, Paula Goodman-Crews, William Rudman, Lawrence J. Schneiderman & Ellen Waldman - 2007 - Journal of Clinical Ethics 18 (2):140-147.
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  10.  33
    The Abuse of Futility.Lawrence J. Schneiderman, Nancy S. Jecker & Albert R. Jonsen - 2018 - Perspectives in Biology and Medicine 60 (3):295-313.
    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. 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 (...)
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  11.  28
    The Physician's Covenant: Images of the Healer in Medical Ethics.Lawrence J. Schneiderman & William F. May - 1984 - Hastings Center Report 14 (3):41.
    Book reviewed in this article: The Physician's Covenant: Images of the Healer in Medical Ethics. By William F. May.
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  12.  85
    How Can Hospital Futility Policies Contribute to Establishing Standards of Practice?Lawrence J. Schneiderman & Alexander Morgan Capron - 2000 - Cambridge Quarterly of Healthcare Ethics 9 (4):524-531.
    A few years ago a battered infant was admitted to a California hospital. After a period of observation and testing, the physicians concluded that the infant had been beaten so badly that his brain was almost completely destroyed, leaving him permanently unconscious. The hospital had just adopted a policy specifying that life-sustaining treatment for permanent unconsciousness was futile and, therefore, not indicated. According to this policy, after suitable subspecialty consultations and deliberations, including efforts to gain parental agreement and documentation of (...)
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  13.  39
    Cost-Effectiveness Analysis In Health Care.Danielle Dolenc Emery & Lawrence J. Schneiderman - 1989 - Hastings Center Report 19 (4):8-13.
    Cost‐effectiveness analysis (CEA) raises questions that are too important to be left to policy analysts and economists. Those who utilize CEA should acknowledge its inherent value system and adapt it to a more ethical usage.
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  14. Do physicians' own preferences for life-sustaining treatment influence their perceptions of patients' preferences? A second look.Lawrence J. Schneiderman, Robert M. Kaplan, Esther Rosenberg & Holly Teetzel - 1997 - Cambridge Quarterly of Healthcare Ethics 6 (2):131-.
    Previous studies have documented the fallibility of attempts by surrogates and physicians to act in a substituted judgment capacity and predict end-of-life treatment decisions on behalf of patients. We previously reported that physicians misperceive their patients' preferences and substitute their own preferences for those of their patients with respect to four treatments: cardiopulmonary resuscitation in the event of cardiac arrest, ventilator for an indefinite period of time, medical nutrition and hydration for an indefinite period of time, and hospitalization in the (...)
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  15.  93
    Judging Medical Futility: An Ethical Analysis of Medical Power and Responsibility.Nancy S. Jecker & Lawrence J. Schneiderman - 1995 - Cambridge Quarterly of Healthcare Ethics 4 (1):23.
    In situations where experience shows that a particular intervention will not benefit a patient, common sense seems to suggest that the intervention should not be used. Yet it is precisely in these situations that a peculiar ethic begins to operate, an ethic that Eddy calls “the criterion of potential benefit.” According to this ethic, “a treatment is appropriate if it might have some benefit.” Thus, the various maxims learned in medical school instruct physicians that “‘an error of commission is to (...)
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  16.  78
    The (Alternative) Medicalization of Life.Lawrence J. Schneiderman - 2003 - Journal of Law, Medicine and Ethics 31 (2):191-197.
    The writers in this symposium are drawn together under the topic of medicine — not to discuss any new discovery in the prevention or treatment of disease. Quite the contrary. We are drawn here to consider a phenomenon. We are here to consider whether a collective romantic fantasy called alternative medicine that has seized our society really deserves the acclaim it is receiving. This, for the most part, is what people like us do when we gather in symposia or meetings (...)
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  17.  83
    Is the Treatment Beneficial, Experimental, or Futile?Lawrence J. Schneiderman & Nancy S. Jecker - 1996 - Cambridge Quarterly of Healthcare Ethics 5 (2):248.
    D.T. a 35-year-old woman, was found to have breast cancer. At the time of mastectomy axillary lymph nodes were positive and the cancer was classified as adenocarcinoma, grade 4. The patient underwent conventional chemotherapy. When it became apparent the disease was metastatic, the patient's oncologist contacted a well-known cancer center regarding the possibility of treating the patient with high dose chemotherapy and autologous bone marrow transplantation. The patient's health insurance provider informed the patient, however, that the treatment—estimated to cost in (...)
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  18.  42
    Exile and PVS.Lawrence J. Schneiderman - 1990 - Hastings Center Report 20 (3):5-5.
    PVS may be a modern form of an ancient punishment, exile from human community.
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  19.  90
    The Baby K Case: A Search for the Elusive Standard of Medical Care.Lawrence J. Schneiderman & Sharyn Manning - 1997 - Cambridge Quarterly of Healthcare Ethics 6 (1):9-18.
    An anencephalic infant, who came to be known as Baby K, was born at Fairfax Hospial in Falls Church, Virginia, on October 13, 1992. From, the moment of birth and repeatedly thereafter, the baby's mother insisted that aggressive measures be pursued, including cardiopulmonary resuscitation and ventilator support, to keep the baby alive as long as possible. The physicians complied. However, following the baby's second admission for respiratory failure, the hospital sought declaratory relief from the court permitting it to forgo emergency (...)
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  20.  51
    Case Studies: 'My Husband Won't Tell the Children!'.Nancy Neveloff Dubler & Lawrence J. Schneiderman - 1984 - Hastings Center Report 14 (4):26.
    This factual case study is one of a series demonstrating ethical dilemmas in medicine, science, the social sciences, and public policy. Although the case is based on fact, it has been edited to preserve confidentiality and to emphasize the ethical questions. Readers are invited to submit cases for consideration for this series. Case descriptions should be typed, doubled‐spaced, and should not exceed 750 words.
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  21.  37
    Having Babies at Home: Is It Safe? Is It Ethical?Gerard Alan Hoff & Lawrence J. Schneiderman - 1985 - Hastings Center Report 15 (6):19-27.
    Home births entail a definite small risk, of unknown magnitude. Hospital births entail a wider range of risks, whose magnitude may be large but is also unknown. The morality of home births should be decided on a case‐by‐case basis, according to these priorities: safety of the mother, safety of the fetus, benefit to the fetus, potential benefit to the mother.
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  22.  13
    (1 other version)Attitudes of Seriously Ill Patients toward Treatment that Involves High Costs and Burdens on Others.Robert D. Langer, John P. Anderson, Robert M. Kaplan, Richard Kronick & Lawrence J. Schneiderman - 1994 - Journal of Clinical Ethics 5 (2):109-112.
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  23.  71
    Ethics Committees at Work: A Different Kind of “Prisoner's Dilemma”.Lawrence J. Schneiderman, Nancy S. Jecker, Christine Rozance, Arlene Judith Klotzko & Birgit Friedl - 1995 - Cambridge Quarterly of Healthcare Ethics 4 (4):530.
    A referral was made to our Cardiac Transplant Program for a patient who was in the New Jersey Prison System. The Medical Director of the New Jersey Department of Corrections called regarding a 39-year-old inmate who was being treated in a New Jersey hospital that has a unit for prisoners from a nearby cor- rectional facility. The referring physician described the patient to our Medical Director of heart transplantation as a “murderer” who had been incarcerated since 1987 and sentenced to (...)
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  24.  89
    The Media and the Medical Market.Lawrence J. Schneiderman - 2007 - Cambridge Quarterly of Healthcare Ethics 16 (4):420.
    I briefly discuss three components of the media that play a role in the commercialization of medicine: advertising, television dramas, and journalism.
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  25.  29
    Distinguishing between Effect and Benefit.Carol A. Riddick & Lawrence J. Schneiderman - 1994 - Journal of Clinical Ethics 5 (1):41-43.
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  26.  43
    Case Study: The Limits of Dispute Resolution.Lawrence J. Schneiderman, Jerry E. Fein & Nancy Dubler - 2001 - Hastings Center Report 31 (6):10.
  27.  87
    Commentary: Weighing and Comparing Expert Testimony by Medical Ethicists.Lawrence J. Schneiderman - 2000 - Journal of Law, Medicine and Ethics 28 (3):236-239.
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  28.  31
    Is It Morally Justifiable Not to Sedate This Patient Before Ventilator Withdrawal?Lawrence J. Schneiderman - 1991 - Journal of Clinical Ethics 2 (2):129-130.
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  29.  45
    In Medicine, Linking Metaphors and Numbers.Lawrence J. Schneiderman - 1984 - Hastings Center Report 14 (3):41-42.
    Book reviewed in this article: The Physician's Covenant: Images of the Healer in Medical Ethics. By William F. May.
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  30.  61
    Response to Open Peer Commentaries on “Rationing Just Medical Care”.Lawrence J. Schneiderman - 2011 - American Journal of Bioethics 11 (10):W1 - W3.
    The American Journal of Bioethics, Volume 11, Issue 10, Page W1-W3, October 2011.
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  31.  46
    Still Saving the Life of Ethics.Lawrence J. Schneiderman - 1990 - Hastings Center Report 20 (6):22-24.
  32.  31
    Wrong Medicine. [REVIEW]Jeremy Sugarman, Lawrence J. Schneiderman & Nancy S. Jecker - 1996 - Hastings Center Report 26 (3):41.
    Book reviewed in this article: Wrong Medicine. By Lawrence J. Schneiderman and Nancy S. Jecker.
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  33. Response to “Reading Futility: Reflections on a Bioethical Concept” by Donald Joralemon , The Rise and Fall of Death: The Plateau of Futility. [REVIEW]Lawrence J. Schneiderman, Holly Teetzel & Todd Gilmer - 2003 - Cambridge Quarterly of Healthcare Ethics 12 (3):308-309.
    Researchers tracking social trends have discovered a remarkable labor-saving device called the computer. They sit down before the instrument, call up a search engine, enter a key word that they believe represents the trend, and count the number of articles aroused by that key word. They track these numbers over a period of time and even graph them. Those who dislike a certain concept are happy to report the concept's rise and fall. Such has occurred with two articles, one of (...)
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  34.  67
    Miracles or limits: What message from the medical marketplace? [REVIEW]Sharyn Manning & Lawrence J. Schneiderman - 1996 - HEC Forum 8 (2):103-108.