Abstract:
:A 13-year-old patient named Jahi McMath was determined to be dead by neurologic criteria following cardiopulmonary arrest and resuscitation at a hospital in Oakland, California. Her family did not agree that she was dead and refused to allow her ventilator to be removed. The family's attorney stated in the media that families, rather than physicians, should decide whether patients are dead and argued in the courts that the families' constitutional rights of religion and privacy would be violated otherwise. Ultimately, a judge agreed that the patient was dead in keeping with California law, but the constitutional issue was undecided. The patient was then transferred to a hospital in New Jersey, a state whose laws allow families to require on religious grounds that death be determined by cardiopulmonary criteria. Although cases such as this are uncommon, they demonstrate public confusion about the concept of neurologic death and the rejection of this concept by some families. The confusion may be caused in part by a lack of uniformity in state laws regarding the legal basis of death, as reflected in the differences between New Jersey and California statutes. Families who reject the determination of death by neurologic criteria on religious grounds should be given reasonable accommodation in all states, but society should not pay for costly treatments for patients who meet these criteria unless the state requires it, as only New Jersey does. Laws that give physicians the right to determine death by neurologic criteria in other states probably can survive a constitutional challenge. Physicians and hospitals faced with similar cases in the future should follow state laws and work through the courts if necessary.
journal_name
Chestjournal_title
Chestauthors
Luce JMdoi
10.1378/chest.14-2227subject
Has Abstractpub_date
2015-04-01 00:00:00pages
1144-1151issue
4eissn
0012-3692issn
1931-3543pii
S0012-3692(15)38965-0journal_volume
147pub_type
杂志文章相关文献
CHEST文献大全abstract::Men who snore heavily have an increased incidence of hypertension, angina, stroke, and neuropsychologic dysfunction, which may be due to nocturnal oxygen desaturation. Nocturnal oxygen therapy might be beneficial to such individuals by improving oxygenation and relieving tissue hypoxia. Twenty-eight asymptomatic heavy...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.92.3.411
更新日期:1987-09-01 00:00:00
abstract::The clinical spectrum of mitochondrial diseases has expanded dramatically in the last decade. Abnormalities of mitochondrial function are now thought to participate in a number of common adult diseases, ranging from exercise intolerance to aging. This review outlines the common presentations of mitochondrial disease i...
journal_title:Chest
pub_type: 杂志文章,评审
doi:10.1378/chest.120.2.634
更新日期:2001-08-01 00:00:00
abstract::This article addresses two basic questions about ethics committees: why we have them, and how they might be helpful to clinicians. Our answer to the first question is twofold. First, we suggest that legal, regulatory, and professional forces drove the development of ethics committees, particularly as an alternative to...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.08-0136
更新日期:2008-08-01 00:00:00
abstract::The aim of this prospective study was to determine the rate of recurrence for spontaneous pneumothorax (SP) after tetracycline pleurodesis (TCP), using that of observation, tube thoracostomy alone, and thoracotomy as references. From 1985 to the end of 1991, 78 patients were treated with tetracycline pleurodesis and 1...
journal_title:Chest
pub_type: 临床试验,杂志文章
doi:10.1378/chest.106.2.347
更新日期:1994-08-01 00:00:00
abstract:STUDY OBJECTIVES:To determine whether the quantitative evaluation of hemomediastinum using transesophageal echocardiography (TEE) is predictive of the presence of a traumatic disruption of the thoracic aorta (TDA) or its branches in patients who have sustained severe blunt chest trauma. DESIGN:Retrospective study. SE...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.113.6.1475
更新日期:1998-06-01 00:00:00
abstract::We report a patient with ischemic cardiomyopathy who was treated with a continuous high dose infusion of intravenous nitroglycerin for six months while awaiting cardiac transplantation. Surprisingly, methemoglobinemia did not develop and nitroglycerin continued to be clinically effective in relieving angina during the...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.100.5.1470
更新日期:1991-11-01 00:00:00
abstract:OBJECTIVE:The measurement of esophageal pressure (Pes) is the conventional method for the evaluation of the forces applied to the respiratory system by the respiratory muscles. As an alternative to Pes measurement, we propose the calculation of the instantaneous net pressure applied by the respiratory muscles [Pmusc(t)...
journal_title:Chest
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1378/chest.108.1.208
更新日期:1995-07-01 00:00:00
abstract:STUDY OBJECTIVE:To assess factors associated with initiating therapy and compliance with treatment for latent tuberculosis infection among health-care workers with positive tuberculin skin test results. DESIGN:Prospective cohort study. SETTING:An urban midwestern teaching hospital in St. Louis, MO. STUDY POPULATION:...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.122.5.1609
更新日期:2002-11-01 00:00:00
abstract:BACKGROUND:In pulmonary sarcoidosis, the optimal means of quantifying change is uncertain. The comparative usefulness of simple lung function trends and chest radiography remains unclear. We aimed to explore and contrast the disease-monitoring strategies of serial pulmonary function tests (PFTs) and chest radiography c...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.12-2479
更新日期:2014-01-01 00:00:00
abstract:STUDY OBJECTIVE:To demonstrate an association between saprophytic fungal infections occurring at the bronchial anastomosis (BA) and the development of additional complications arising at this site. DESIGN:Retrospective review. SETTING:University lung transplant center. MATERIALS AND METHODS:Review of all single-lung...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.122.4.1185
更新日期:2002-10-01 00:00:00
abstract:BACKGROUND:Therapist-implemented protocols have been used to extubate or wean patients in the ICU setting. Barlow Respiratory Hospital (BRH) functions as a center for weaning patients from prolonged mechanical ventilation (PMV) in the post-ICU setting of a long-term acute-care (LTAC) facility. A therapist-implemented p...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.119.1.236
更新日期:2001-01-01 00:00:00
abstract::This study was undertaken to determine if the production of pulsatile flow by the intra-aortic balloon pump during cardiopulmonary bypass has any beneficial effect on coronary flow, regional myocardial flow, myocardial metabolism, and left ventricular function. Thirty-six conditioned dogs were subjected to one hour of...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.75.1.37
更新日期:1979-01-01 00:00:00
abstract:BACKGROUND:Obesity is known to be an important risk factor for OSA; however, OSA can also be seen in nonobese patients with a small maxilla and/or mandible as well as in all obese patients with such features. Thus, we hypothesized that regional factors, oropharyngeal crowding associated with fat deposition, and maxillo...
journal_title:Chest
pub_type: 杂志文章
doi:10.1016/j.chest.2016.03.005
更新日期:2016-08-01 00:00:00
abstract::A 54-year-old man was referred with nonresolving pneumonia. He had been treated for community-acquired pneumonia 6 weeks earlier. He reported grade 2 dyspnea, malaise, and a nonproductive cough. He had also experienced three episodes of minimal hemoptysis but denied weight loss, fever, or any other constitutional symp...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.13-2790
更新日期:2014-09-01 00:00:00
abstract::Respiratory rate is a sensitive clinical parameter in a multitude of pulmonary diseases, especially in the critical care setting. In order to validate the routine recording of the respiratory rate in the intensive care unit, we compared the values obtained from the nursing records with the breathing frequency continuo...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.90.5.632
更新日期:1986-11-01 00:00:00
abstract::The endocrinometabolic effects of the aerosol administration of beclomethasone dipropionate (100 microng four times daily) were evaluated in 20 asthmatic patients (11 corticodependent and nine noncorticodependent) during one month. In the noncorticodependent group, aerosol administration of beclomethasone had no stati...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.71.6.698
更新日期:1977-06-01 00:00:00
abstract::We evaluated two patients with systemic cholesterol embolization (SCE) associated with the development of pleural effusions. These two patients had evidence of atherosclerosis and presented with livedo reticularis, renal insufficiency, and gangrenous cutaneous changes as manifestations of their SCE. In both cases, clo...
journal_title:Chest
pub_type: 杂志文章,评审
doi:10.1378/chest.103.3.792
更新日期:1993-03-01 00:00:00
abstract:BACKGROUND:Gender differences in the prevalence of various manifestations of obstructive sleep apnea syndrome (OSAS) is not as great as previously believed. The aim of the present study was to clarify the clinical patient characteristics of Japanese women and men with OSAS. METHODS:A cross-sectional case-match control...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.08-1414
更新日期:2009-02-01 00:00:00
abstract:BACKGROUND:Up-to-date estimates of burden of diseases are required for evidence-based decision-making. The objectives of this study were to determine the excess costs of COPD and its trend from 2001 to 2010 in British Columbia, Canada. METHODS:We used British Columbia's administrative health data to construct a cohort...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.15-0721
更新日期:2015-09-01 00:00:00
abstract::The ventilatory effects of a bolus intravenous dose of doxapram (0.37 to 0.47 mg/kg) were studied in ten healthy normal subjects. An immediate significant (p less than 0.001) increase in minute ventilation (VE) was due, in equal part, to significant increases in tidal volume (VT) and frequency (f). The inspiratory (TI...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.85.5.600
更新日期:1984-05-01 00:00:00
abstract:OBJECTIVE:The epigenetic basis for human asthma is not well studied, particularly among older adults. This study investigated the methylation profiles in sputum DNA among older adults with asthma, using a population of smokers. METHODS:This was a cross-sectional study using the Lovelace Smokers Cohort, a population of...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.11-2519
更新日期:2012-08-01 00:00:00
abstract::It has been observed that T-lymphocytes of patients with tuberculosis produce interferon gamma (IFN gamma) in vitro. Based on this idea, we studied IFN gamma in pleural fluid and serum. We studied 80 patients with pleural effusion; 30 patients with tuberculous pleurisy had high IFN gamma concentrations in pleural flui...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.93.2.308
更新日期:1988-02-01 00:00:00
abstract::Two cases of a Greenfield inferior vena cava (IVC) filter being dislodged during central venous catheter placement are described. This event appears to be related to J-tip guidewire use during venous catheterization. To our knowledge, this occurrence previously has not been reported. One of the two filters was dislodg...
journal_title:Chest
pub_type: 杂志文章,评审
doi:10.1378/chest.106.3.957
更新日期:1994-09-01 00:00:00
abstract:BACKGROUND:Clinical practice guidelines recommend enteral over parenteral nutrition in critical illness and do not recommend early initiation. Few data are available on parenteral nutrition use or timing of initiation in the ICU or how this use may have changed over time. METHODS:We used the Project IMPACT database to...
journal_title:Chest
pub_type: 杂志文章,多中心研究
doi:10.1378/chest.13-1597
更新日期:2014-03-01 00:00:00
abstract:BACKGROUND:International time trends in asthma mortality have played an important sentinel role in the identification of two epidemics of asthma mortality in some countries in the 1960s and the 1970s and 1980s. Since then, little attention has been paid to the ongoing international time trends. METHODS:Country-specifi...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.08-2082
更新日期:2009-04-01 00:00:00
abstract::In order to determine the effect of electrode placement and standing on the 12-lead electrocardiogram required prior to exercise testing, 104 male patients with stable coronary heart disease were studied. Electrocardiograms were recorded with two different placements of the arm electrodes commonly used for exercise te...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.85.5.616
更新日期:1984-05-01 00:00:00
abstract::Due to concerns about the efficacy and safety of using pulmonary artery catheterization to evaluate hemodynamic status, noninvasive diagnostic testing has gained increased importance. This article focuses on both the supportive evidence and the limitations of applying the vascular pedicle width (VPW), which is the med...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.121.3.942
更新日期:2002-03-01 00:00:00
abstract::Immune checkpoint inhibitors (ICIs) are newer, immunotherapy-based drugs that have been shown to improve survival in advanced non-small cell lung cancer (NSCLC). Unlike traditional chemotherapeutic agents, ICIs work by boosting the body's natural tumor killing response. However, this unique mechanism of action has als...
journal_title:Chest
pub_type: 杂志文章,评审
doi:10.1016/j.chest.2018.08.1048
更新日期:2018-12-01 00:00:00
abstract::Increased blood lactate concentration (hyperlactatemia) and lactic acidosis (hyperlactatemia and serum pH < 7.35) are common in patients with severe sepsis or septic shock and are associated with significant morbidity and mortality. In some patients, most of the lactate that is produced in shock states is due to inade...
journal_title:Chest
pub_type: 杂志文章,评审
doi:10.1378/chest.15-1703
更新日期:2016-01-01 00:00:00
abstract::Tests of overall lung function often reveal abnormalities in elderly smokers, but lung function is less consistently deranged in young smokers. Since airway closure at higher than normal lung volumes is thought to be an early indicator of lung dysfunction in asymptomatic smokers, we used 133xenon to measure regional r...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.79.1.12
更新日期:1981-01-01 00:00:00