Prolonging life: legal, ethical, and social dilemmas.

Abstract:

:The ability of modern medicine to prolong life has raised a variety of difficult legal, ethical, and social issues on which reasonable minds can differ. Among these are the morality of euthanasia in cases of deep coma or irreversible injury, as well as the Dead Donor Rule with respect to organ harvesting and transplants. As science continues to refine and develop lifesaving technologies, questions remain as to how much medical effort and financial resources should be expended to prolong the lives of patients suspended between life and death. At what point should death be considered irreversible? What criteria should be used to determine when to withhold or withdraw life-prolonging treatments in cases of severe brain damage and terminal illness? To explore these complex dilemmas, Steve Paulson, executive producer and host of To the Best of Our Knowledge, moderated a discussion panel. Pediatrician Sam Shemie, hospice medical director Christopher P. Comfort, bioethicist Mildred Z. Solomon, and attorney Barbara Coombs Lee examined the underlying assumptions and considerations that ultimately shape individual and societal decisions surrounding these issues. The following is an edited transcript of the discussion that occurred November 12, 2013, 7:00-8:30 PM, at the New York Academy of Sciences in New York City.

journal_name

Ann N Y Acad Sci

authors

Paulson S,Comfort CP,Lee BC,Shemie S,Solomon MZ

doi

10.1111/nyas.12476

subject

Has Abstract

pub_date

2014-11-01 00:00:00

pages

19-37; discussion 38-9

eissn

0077-8923

issn

1749-6632

journal_volume

1330

pub_type

杂志文章
  • Dopamine, acetylcholine, and glutamate interactions in aging. Behavioral and neurochemical correlates.

    abstract::Aging, hypoxia, and thiamin deficiency diminish motor performance. Similar alterations of ACh, DA, and glutamate metabolism accompany hypoxia, thiamin deficiency, and aging. Both aging and hypoxia reduce ACh release and stimulate DA and glutamate release. Presynaptic enhancement of DA and glutamate release may be impo...

    journal_title:Annals of the New York Academy of Sciences

    pub_type: 杂志文章

    doi:10.1111/j.1749-6632.1988.tb32984.x

    authors: Freeman GB,Gibson GE

    更新日期:1988-01-01 00:00:00

  • Detection of Astrakhan fever rickettsia from ticks in Kosovo.

    abstract::Astrakhan fever is a summer spotted fever resembling Mediterranean spotted fever, endemic in Astrakhan, a region of Russia located by the Caspian sea. Its agent is a spotted fever group rickettsia, member of the Rickettsia conorii complex, transmitted to humans by Rhipicephalus sanguineus and Rhipicephalus pumilio tic...

    journal_title:Annals of the New York Academy of Sciences

    pub_type: 杂志文章

    doi:10.1111/j.1749-6632.2003.tb07357.x

    authors: Fournier PE,Durand JP,Rolain JM,Camicas JL,Tolou H,Raoult D

    更新日期:2003-06-01 00:00:00

  • Involvement of endocannabinoid CB1 receptor in the modulation of stress responses related to xenoestrogen exposure.

    abstract::The endocannabinoid system, through the cannabinoid receptor CB1, is involved in the modulation of adaptive responses to environmental conditions. However, little is known about the role of the cannabinergic system, particularly CB1 receptor expression, in relation to the effects induced by xenoestrogens concerning th...

    journal_title:Annals of the New York Academy of Sciences

    pub_type: 杂志文章

    doi:10.1111/j.1749-6632.2009.04455.x

    authors: Palermo FA,Angelini M,Cottone E,Virgili M,Franzoni MF,Mosconi G,Polzonetti-Magni AM

    更新日期:2009-04-01 00:00:00

  • Cells in the supraoculomotor area in monkeys with strabismus show activity related to the strabismus angle.

    abstract::We have earlier shown that monkeys reared with daily alternating monocular occlusion for the first few months of life develop large horizontal strabismus, A/V patterns, dissociated vertical deviation (DVD), and dissociated horizontal deviation (DHD). Here, we present results from neurophysiological experiments that sh...

    journal_title:Annals of the New York Academy of Sciences

    pub_type: 杂志文章

    doi:10.1111/j.1749-6632.2011.06146.x

    authors: Das VE

    更新日期:2011-09-01 00:00:00

  • Stem cell transplantation across major genetic barriers.

    abstract::Megadose haploidentical transplants, mismatched at three HLA loci, engraft rapidly and durably without induction of graft-versus-host disease (GVHD). In vitro studies suggest that veto cells, contained in the population of hematopoietic progenitors, facilitate this favorable outcome. Cytotoxic T cells, not reactive ag...

    journal_title:Annals of the New York Academy of Sciences

    pub_type: 杂志文章,评审

    doi:

    authors: Reisner Y

    更新日期:2001-06-01 00:00:00

  • The effect of fasting and vitamin E on insulin action in obese type 2 diabetes mellitus.

    abstract::The influence of either short-term fasting or vitamin E administration on insulin action was studied in two groups of obese Type 2 diabetic patients. Twelve patients underwent 7 days of fasting (group A), whereas 600 mg of vitamin E was administered daily during 3 months in 9 diabetic patients (group B). Insulin actio...

    journal_title:Annals of the New York Academy of Sciences

    pub_type: 杂志文章

    doi:10.1111/j.1749-6632.1997.tb51870.x

    authors: Skrha J,Sindelka G,Hilgertová J

    更新日期:1997-09-20 00:00:00

  • Esophageal tissue engineering: from bench to bedside.

    abstract::For various esophageal diseases, the search for alternative techniques for tissue repair has led to significant developments in basic and translational research in the field of tissue engineering. Applied to the esophagus, this concept is based on the in vitro combination of elements judged necessary for in vivo impla...

    journal_title:Annals of the New York Academy of Sciences

    pub_type: 杂志文章,评审

    doi:10.1111/nyas.13951

    authors: Arakelian L,Kanai N,Dua K,Durand M,Cattan P,Ohki T

    更新日期:2018-12-01 00:00:00

  • Effect of saiboku-to (TJ-96) on bronchial asthma. Induction of glucocorticoid receptor, beta-adrenaline receptor, IgE-Fc epsilon receptor expression and its effect on experimental immediate and late asthmatic reaction.

    abstract::A remarkable "steroid sparing" effect of Saiboku-to was noted within 6 to 12 months of treatment in steroid-dependent asthmatic patients. Saiboku-to spared the downregulation of glucocorticoid receptor of human lymphocytes, plasma ACTH, and cortisol levels. It also spared downregulation of beta 2 receptor by beta 2 ag...

    journal_title:Annals of the New York Academy of Sciences

    pub_type: 杂志文章

    doi:10.1111/j.1749-6632.1993.tb35918.x

    authors: Nakajima S,Tohda Y,Ohkawa K,Chihara J,Nagasaka Y

    更新日期:1993-06-23 00:00:00

  • Endogenous ligands of imidazoline receptors: classic and immunoreactive clonidine-displacing substance and agmatine.

    abstract::1. There are several endogenous ligands that bind to I-receptors of both the I1 and I2 subclass. These include: (a) classic CDS, a partially purified entity isolated by the criteria that it displaces binding ligands to alpha 2- and I-receptors; (b) immunoreactive (ir)-CDS, a moiety that binds to antibodies raised agai...

    journal_title:Annals of the New York Academy of Sciences

    pub_type: 杂志文章,评审

    doi:10.1111/j.1749-6632.1995.tb32416.x

    authors: Reis DJ,Li G,Regunathan S

    更新日期:1995-07-12 00:00:00

  • An integrated strategy for evaluation of metabolic and oxidative defects in neurodegenerative illness using magnetic resonance techniques.

    abstract::The number of physiologic and metabolic phenomena amenable to analysis using magnetic resonance (MR) techniques is increasing every year. MR techniques can now evaluate tissue parameters relevant to TCA cyclemetabolism, anerobic glycolysis, ATP levels, blood-brain barrier permeability, macrophage infiltration, cytotox...

    journal_title:Annals of the New York Academy of Sciences

    pub_type: 杂志文章,评审

    doi:10.1111/j.1749-6632.1999.tb07828.x

    authors: Jenkins BG,Chen YI,Kuestermann E,Makris NM,Nguyen TV,Kraft E,Brownell AL,Rosas HD,Kennedy DN,Rosen BR,Koroshetz WJ,Beal MF

    更新日期:1999-01-01 00:00:00

  • Stress, leukocyte trafficking, and the augmentation of skin immune function.

    abstract::Delayed type hypersensitivity (DTH) reactions represent cell-mediated immune responses that exert important immunoprotective (resistance to viruses, bacteria, and fungi) or immunopathologic (allergic or autoimmune hypersensitivity) effects. We have used the skin DTH response as an in vivo model to study neuro-endocrin...

    journal_title:Annals of the New York Academy of Sciences

    pub_type: 杂志文章,评审

    doi:10.1111/j.1749-6632.2003.tb03151.x

    authors: Dhabhar FS

    更新日期:2003-05-01 00:00:00

  • What effect does controlling platelets have on atherosclerosis?

    abstract::Platelets play important roles for hemostasis with activated platelets adhering to the injured vessel wall to initiate platelet aggregation. At the same time, our study revealed the cytotoxic effect on endothelial cells characterized by an increase of intracellular Ca++ and a decrease of EDRF production, which may cau...

    journal_title:Annals of the New York Academy of Sciences

    pub_type: 杂志文章

    doi:10.1111/j.1749-6632.1994.tb17334.x

    authors: Numano F,Kishi Y,Ashikaga T,Hata A,Makita T,Watanabe R

    更新日期:1995-01-17 00:00:00

  • Protective effects of piceatannol against beta-amyloid-induced neuronal cell death.

    abstract::Beta-amyloid (Abeta) is a main component of senile plaques in Alzheimer's disease (AD) that induces neuronal cell death. Since reactive oxygen species (ROS) have been implicated in Abeta-induced neurotoxicity, considerable attention has recently been focused on identifying naturally occurring antioxidative phenolic ph...

    journal_title:Annals of the New York Academy of Sciences

    pub_type: 杂志文章

    doi:10.1196/annals.1397.051

    authors: Kim HJ,Lee KW,Lee HJ

    更新日期:2007-01-01 00:00:00

  • Multifunctionalized biocompatible microspheres for sensing.

    abstract::We present our achievements in the synthesis and application of multifunctionalized, cross-linked, polystyrene microspheres, which remarkably and quite generally are taken up by all cell types studied to date. Importantly, the nature of these synthetic beads allows multistep solid-phase chemistry and the ability to bi...

    journal_title:Annals of the New York Academy of Sciences

    pub_type: 杂志文章,评审

    doi:10.1196/annals.1430.004

    authors: Sánchez-Martín RM,Alexander L,Bradley M

    更新日期:2008-01-01 00:00:00

  • Effects of low-molecular-weight heparin on adhesion and vesiculation of phospholipid membranes: a possible mechanism for the treatment of hypercoagulability in antiphospholipid syndrome.

    abstract::Heparins represent an efficient treatment of acute thrombosis and obstetric complications in antiphospholipid syndrome (APS). Enhanced microvesiculation of cell membranes, as detected by reduced membrane adhesion, can contribute to hypercoagulability in APS. Healthy donor IgG antibodies significantly increased beta2-g...

    journal_title:Annals of the New York Academy of Sciences

    pub_type: 杂志文章

    doi:10.1111/j.1749-6632.2009.04745.x

    authors: Frank M,Sodin-Semrl S,Rozman B,Potocnik M,Kralj-Iglic V

    更新日期:2009-09-01 00:00:00

  • How Wnt signaling affects bone repair by mesenchymal stem cells from the bone marrow.

    abstract::Human mesenchymal stem cells (hMSCs) from bone marrow are a source of osteoblast progenitors in vivo, and under appropriate conditions they differentiate into osteoblasts ex vivo. The cells provide a convenient cell culture model for the study of osteogenic tissue repair in an experimentally accessible system. Recent ...

    journal_title:Annals of the New York Academy of Sciences

    pub_type: 杂志文章,评审

    doi:10.1196/annals.1334.010

    authors: Gregory CA,Gunn WG,Reyes E,Smolarz AJ,Munoz J,Spees JL,Prockop DJ

    更新日期:2005-05-01 00:00:00

  • Quantum dot-based mortalin staining as a visual assay for detection of induced senescence in cancer cells.

    abstract::Quantum dots (QDs) are fluorescent nanocrystals that are emerging as fine alternatives to the conventional organic dyes. They have several advantages including greater photostability and a wider range of excitation-emission wavelengths. By using mortalin staining as a model, we initially demonstrated that the QDs are ...

    journal_title:Annals of the New York Academy of Sciences

    pub_type: 杂志文章

    doi:10.1196/annals.1395.040

    authors: Kaul Z,Yaguchi T,Chiura HX,Kaul SC,Wadhwa R

    更新日期:2007-04-01 00:00:00

  • Dendritic cell-based vaccine against coccidioides infection.

    abstract::Coccidioides causes coccidioidomycosis in the southwestern United States. Its clinical manifestations range from the primary asymptomatic to progressive pulmonary and extrapulmonary disease. Because of endemicity, frequent relapse, and virulent nature of Coccidioides, there is an urgent need for the development of eff...

    journal_title:Annals of the New York Academy of Sciences

    pub_type: 杂志文章,评审

    doi:10.1196/annals.1406.013

    authors: Awasthi S

    更新日期:2007-09-01 00:00:00

  • Ketosis leads to increased methylglyoxal production on the Atkins diet.

    abstract::In the popular and widely used Atkins diet, the body burns fat as its main fuel. This process produces ketosis and hence increased levels of beta-hydroxybutyrate (BOB) acetoacetate (AcAc) and its by-products acetone and acetol. These products are potential precursors of the glycotoxin methylglyoxal. Since methylglyoxa...

    journal_title:Annals of the New York Academy of Sciences

    pub_type: 杂志文章

    doi:10.1196/annals.1333.025

    authors: Beisswenger BG,Delucia EM,Lapoint N,Sanford RJ,Beisswenger PJ

    更新日期:2005-06-01 00:00:00

  • Clinical and experimental studies on adenine, various nucleosides and their analogs in hematology.

    abstract::In red blood cells as well as in platelets there appears to be a decrease in adenine nucleotides during storage under blood bank conditions. This can be decreased by use of anticoagulant preservatives with higher phosphate content than the standard ACD solution, through the addition of adenine and inosine. Maintenance...

    journal_title:Annals of the New York Academy of Sciences

    pub_type: 杂志文章,评审

    doi:10.1111/j.1749-6632.1975.tb29250.x

    authors: Ambrus JL,Ambrus CM,Odake K,Mink IB,Shields R,Warner W,Bishop C,Tritsch GL,Golden G,Mittelman A

    更新日期:1975-08-08 00:00:00

  • Biobehavioral indices of emotion regulation relate to school attitudes, motivation, and behavior problems in a low-income preschool sample.

    abstract::Effective emotion regulation may promote resilience and preschool classroom adjustment by supporting adaptive peer interactions and engagement in learning activities. We investigated how hypothalamus-pituitary-adrenal axis (HPA) regulation, cardiac reactivity, and classroom emotion displays related to adjustment among...

    journal_title:Annals of the New York Academy of Sciences

    pub_type: 杂志文章

    doi:10.1196/annals.1376.043

    authors: Miller AL,Seifer R,Stroud L,Sheinkopf SJ,Dickstein S

    更新日期:2006-12-01 00:00:00

  • Sex hormones and risk of liver tumor.

    abstract::The liver is morphologically and functionally modulated by sex hormones. Long-term use of oral contraceptives (OCs) and anabolic androgenic steroids (AASs) can induce both benign (hemangioma, adenoma, and focal nodular hyperplasia [FNH]) and malignant (hepatocellular carcinoma [HCC]) hepatocellular tumors. Hepatic ade...

    journal_title:Annals of the New York Academy of Sciences

    pub_type: 杂志文章,评审

    doi:10.1196/annals.1386.044

    authors: Giannitrapani L,Soresi M,La Spada E,Cervello M,D'Alessandro N,Montalto G

    更新日期:2006-11-01 00:00:00

  • The Ah receptor in stem cell cycling, regulation, and quiescence.

    abstract::Processes that regulate quiescence, self-renewal, and differentiation of hematopoietic stem cells (HSCs) are not well understood. Owing, in part, to the ability of xenobiotic ligands to have persistent effects on the immune system in experimental animals, there has been much work to define a physiological role of the ...

    journal_title:Annals of the New York Academy of Sciences

    pub_type: 杂志文章,评审

    doi:10.1111/nyas.12361

    authors: Gasiewicz TA,Singh KP,Bennett JA

    更新日期:2014-03-01 00:00:00

  • Immortalized pancreatic duct cells in vitro and in vivo.

    abstract::Although pancreatic adenocarcinoma has become one of the best characterized malignant diseases, severe diagnostic and therapeutic problems are still associated with this disease. The establishment of a molecular model of pancreatic carcinogenesis may provide tools that could result in earlier diagnosis of this disease...

    journal_title:Annals of the New York Academy of Sciences

    pub_type: 杂志文章

    doi:10.1111/j.1749-6632.1999.tb09509.x

    authors: Jesnowski R,Müller P,Schareck W,Liebe S,Löhr M

    更新日期:1999-06-30 00:00:00

  • Food security, poverty, and human development in the United States.

    abstract::Access to food is essential to optimal development and function in children and adults. Food security, food insecurity, and hunger have been defined and a U.S. Food Security Scale was developed and is administered annually by the Census Bureau in its Current Population Survey. The eight child-referenced items now make...

    journal_title:Annals of the New York Academy of Sciences

    pub_type: 杂志文章,评审

    doi:10.1196/annals.1425.001

    authors: Cook JT,Frank DA

    更新日期:2008-01-01 00:00:00

  • Serial analysis of gene expression in the rat striatum following methamphetamine administration.

    abstract::Methamphetamine (METH), a highly addictive drug, can cause degeneration of monoaminergic terminals and neuronal apoptosis in the mammalian brain. In the present article, we have used serial analysis of gene expression (SAGE) to investigate patterns of gene expression in the striata of rats that were given a neurotoxic...

    journal_title:Annals of the New York Academy of Sciences

    pub_type: 杂志文章

    doi:10.1196/annals.1369.002

    authors: Cai NS,McCoy MT,Ladenheim B,Lyles J,Ali SF,Cadet JL

    更新日期:2006-08-01 00:00:00

  • Amyloidogenesis in familial British dementia is associated with a genetic defect on chromosome 13.

    abstract::Familial British dementia (FBD) is a disorder characterized by the presence of amyloid deposits in cerebral blood vessels and brain parenchyma coexisting with neurofibrillary tangles in limbic areas. The amyloid subunit (ABri) is a 4 kDa fragment of a 266 amino acid type II single-spanning transmembrane precursor prot...

    journal_title:Annals of the New York Academy of Sciences

    pub_type: 杂志文章

    doi:10.1111/j.1749-6632.2000.tb06908.x

    authors: Ghiso J,Vidal R,Rostagno A,Miravalle L,Holton JL,Mead S,Révész T,Plant G,Frangione B

    更新日期:2000-01-01 00:00:00

  • Role of PI3K/Akt and mTOR complexes in Th17 cell differentiation.

    abstract::Interleukin (IL)-17-producing helper T (Th17) cells serve as a Th subset involved in epithelial cell- and neutrophil-mediated immune responses against extracellular microbes and in the development of various autoimmune diseases. The differentiation of Th17 cells is controlled by a number of intracellular signaling cas...

    journal_title:Annals of the New York Academy of Sciences

    pub_type: 杂志文章,评审

    doi:10.1111/nyas.12059

    authors: Nagai S,Kurebayashi Y,Koyasu S

    更新日期:2013-03-01 00:00:00

  • The relationship between self-esteem and depression in obese children.

    abstract::It has been suggested that obese children have increased problems with self-esteem and depression when compared to the normal pediatric population. Fifty-one consecutive patients enrolled in a hospital based weight management program received the CDI and the PHSCS as part of their initial evaluation. There were 24 mal...

    journal_title:Annals of the New York Academy of Sciences

    pub_type: 杂志文章

    doi:10.1111/j.1749-6632.1993.tb18869.x

    authors: Sheslow D,Hassink S,Wallace W,DeLancey E

    更新日期:1993-10-29 00:00:00

  • Association between alexithymia and neuroendocrine response to psychological stress in police academy recruits.

    abstract::Alexithymia has been associated with both posttraumatic stress disorder and neuroendocrine responses to stress. This study examined the relationship of alexithymia to salivary cortisol and 3-methoxy-4-hydroxy-phenylglycol (MHPG) in a sample of police academy recruits exposed to a video stress challenge. Alexithymia sc...

    journal_title:Annals of the New York Academy of Sciences

    pub_type: 杂志文章

    doi:10.1196/annals.1364.034

    authors: McCaslin SE,Inslicht SS,Neylan TC,Metzler TJ,Otte C,Lenoci M,Henn-Haase C,Best S,Yehuda R,Marmar CR

    更新日期:2006-07-01 00:00:00