Montana Ruling Legalizes Assisted Suicide

Late Friday night, a Montana judge ruled that physician-assisted suicide for the terminally ill is legal. According to Judge Dorothy McCarter, "The Montana constitutional rights of individual privacy and human dignity, taken together, encompass the right of a competent terminally (ill) patient to die with dignity."

While the Montana attorney general plans to appeal the ruling next week, for at least the time being, the state joins Oregon and Washington in allowing terminally ill patients the choice of when and how they die.
-Kelly Hills

dying from a broken heart

It's always the end of a beautiful story, a powerful love affair. The old and grey couple, together for decades, yearly celebrations of their affirmations and vows, marching through traditional gifts: coral, ruby, sapphires, gold. Surrounded by a field of family, generations stemming out from their love, she passes on, peacefully in the night, and he follows a few days later, his will to live gone without her. The perfect end to the perfect story.

Like most perfect stories, we dismiss it as fantasy. Fewer people these days stay married so long, have so many kids, have so much happiness. And of course, the myth of dying from a broken heart is just that: a myth.

Except, in "news I didn't really want to hear", a study by the Case Business School in London have found people really do die from broken hearts. Men are six times more likely to die in the year after their partner's death, while women are twice as likely to die in that same time. This study is different than those which have come before; a n older study in the American Journal of Public Health shows men more likely to die after their wife, but more from life issues (malnutrition, etc) than grief, while a different Johns Hopkins study published just before Valentine's Day 2005 shows that a rapid increase of stress hormones in highly emotional situations can essentially stun the heart and mimic a heart attack. Instead, this new study, sponsored by the Actuarial Profession, statistically proves people can die of a broken heart in the early stages of bereavement.

Thankfully, there is a bit of positive in this cloud of gloomy news: if the widow or widower survives the first year of mourning, the chances of dying (at least from the broken heart - ie, no clear medical reasons) decrease.

Now the question is: why are men more susceptible to dying from a broken heart, while women are more likely to suffer from immediate emotional shock, and how do we minimize both?
-Kelly

The Logic or Rationale of the DNR Order

Whether we've discussed it or not, we've all thought about the prospect of Do Not Resuscitate Orders (DNRs). In most instances the need for them is no mystery nor does it require rocket science to understand when they become necessary. But now, in 21st century medical science comes the question: when do they not make sense?

See one perspective on a controversial ethics issue here.

do you sing the body electric?

A case going before the Ohio Supreme Court this week has the potential to change autopsies in the state - but also, potentially, surgeries and other procedures. At the heart of the matter is whether or not the state has the right to classify removed portions of the body as medical waste, and dispose of them in a timely fashion, or if those items of the body must eventually be returned to the family/loved ones. The specific plaintiff in this case is the family of a man who was buried without his brain.

The reason for this isn't as gruesome, nor as forensic show plot-y as it sounds. It's actually rather simple; when preparing a brain, during an autopsy, it typically takes longer to prepare the brain for viewing than it does to release the rest of the body for burial/cremation. Once the examination of the brain is done, and final cause of death has been determined, the brain is disposed of like most other medical waste - incineration.

But it raises a host of ethical, legal and social issues. Many people, backed by many different religions, believe that the body must be returned to the ground whole, for various reasons involving religious tenants and the afterlife/Resurrection. Others, perhaps fueled by media reports of wrongdoing on the part of funeral directors and the like, simply fear what is happening to those body parts - are they being used for research without permission? Unauthorized grafts or transplants? They want accountability for the whole of their loved one's body, and feel that it is well within our cultural history to demand it.

The defendants argue that this will severely harm their practice, of forensics and crime scenes, of autopsies, and perhaps more. After all, they point out, when a body dies, fluids - blood and more - are lost at the scene, and this is not collected for return. Likewise, there are times when the entire body simply cannot be returned, due to the natural of the death itself. Or most simply, as attorney Mark Landes has pointed out, it is a definitional impossibility to both do an autopsy and return the entire body.

Unfortunately, this is a situation of cultural and social beliefs hitting up against practical considerations and laws - we need to know how people died, particularly when it is a suspicious death, but we want to respect the religious and cultural beliefs of the people involved. And there are times when the two simply cannot be reconciled - and in those cases, what do you do?

I know what my decision would be - what's yours?
-Kelly

Death Casts a Shadow in the Classroom

The Chicago Tribune explores the heated life and death debate over the role of schools and DNR orders.

Read Katie's story and decide where you stand on the ethics of medical care for severely disabled/terminal children in the classroom.