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Biomedical subjects

James L Werth

Publications and source records attributed to James L Werth.

12 recordsLinked to original sources
PubMed2005

Becky's legacy: personal and professional reflections on loss and hope.

The author, a psychologist who has been specializing in end-of-life issues for over a decade, uses the death of his fiancée (Becky), following the withdrawal of a ventilator and the refusal to place her back on the machine, to discuss research and analysis of end-of-life care in the United States. After briefly discussing his own background, Becky's history, and their relationship, he details Becky's last weeks of life and the first weeks of his grieving process. This story provides a background for discussing end-of-life issues including what constitutes a "good death," concerns about aggressive treatment and the cost of care near the end of life, prognosis, advance directives, and demographic issues. There is also a major section on psychosocial issues that arise when a person is dying. The author concludes with a set of "lessons learned" as a result of his relationship with Becky and going through the dying process with her and her family.

Advance Directives↗
PubMed2005

Characteristics of persons approving of physician-assisted death.

The present study describes the characteristics and attitudes of non-terminally ill persons who support physician-assisted death (PAD) along with their expectations and preferences for care in the future. Participants (N = 101) completed a survey assessing current affect and attitudes and those expected if terminally ill. Participants' responses indicated they were a well-adjusted group with little evidence of depressive symptoms or past suicidal ideation. Current attitudes were differentially related to future care preferences. Findings suggest a need for longitudinal research on the stability of current attitudes and how they relate to PAD among non-terminally ill supporters of assisted death.

Affect↗
PubMed2005

Perceptions concerning college student suicide: data from four universities.

The issue of suicide, including prevention, intervention, and postvention, continues to be a problem on college campuses. For this study, data concerning a variety of issues related to college student suicide were collected from 1,865 students at four different universities. Incidence, risk factors, and potential solutions are described, as well as implications for mental health professionals in university settings.

Adolescent↗
PubMed2004

The relationships among clinical depression, suicide, and other actions that may hasten death.

Clinical depression and other psychological disorders have been associated with suicidal ideation, attempts, and deaths. Because of the link between suicide and mental illness, whenever discussion of "assisted suicide" arises, the possibility that major depression is affecting the decision arises. This article examines the literature on clinical depression as it relates to suicide, "assisted suicide," and other decisions that will hasten death (i.e. withholding and withdrawing treatment, terminal sedation, and voluntarily stopping eating and drinking). Ethical and legal considerations when working with individuals who are considering taking an action that would hasten death are also briefly reviewed. The article ends with practice and policy recommendations.

Attitude to Death↗
PubMed2003

Physician-assisted suicide in Oregon: what are the key factors?

Oregon's Death with Dignity Act has been operative since late 1997. The substantial national and international interest in Oregon's law makes it important to document any possible trends in the characteristics of persons who use the law. To do this, the present article examines previously reported data from various sources and places them within the context of the end-of-life decisions more generally. The Oregon data demonstrate that, regardless of the care received, a very small percentage of terminally ill Oregonians seem determined to request a lethal medication so that they may control the manner and timing of their death. College graduates and divorced persons are substantially more likely to use physician-assisted suicide to end their lives than are other persons. Control and autonomy appear to be the primary issues associated with taking legally prescribed medication to hasten one's death. A better understanding of the influence that a patient's marital status, education level, and desire for control may have on her or his ability to cope with, and make decisions related to, a terminal illness may allow health care professionals to better care for dying patients.

Age Factors↗
PubMed2002

Reinterpreting the controlled substances act: predictions for the effect on pain relief.

On November 6, 2001 U.S. Attorney General Ashcroft reinterpreted the Controlled Substances Act in a manner consistent with the Pain Relief Promotion Act, a bill introduced in the last Congress. This reinterpretation criminalizes actions related to the provision of controlled substances (e.g. opioids, barbiturates) in the event that a patient dies and external observers believe the intent of providing the medication was to hasten the patient's death. This paper analyzes the arguments regarding the need for reinterpretation and the potential consequences of such an action on pain relief. The conclusion is that the weight of the data clearly leads to the prediction that this reinterpretation of the Controlled Substances Act will lead physicians to be less likely to provide adequate types and doses of pain medication to patients who may die.

Drug and Narcotic Control↗
PubMed2002

Confidentiality in end-of-life and after-death situations.

Confidentiality is one of the foundations on which psychotherapy is built. Limitations on confidentiality in the therapeutic process have been explained and explored by many authors and organizations. However, controversy and confusion continue to exist with regard to the limitations on confidentiality in situations where clients are considering their options at the end of life and after a client has died. This article review these 2 areas and provides some suggestions for future research.

Attitude of Health Personnel↗
PubMed1999

When is a mental health professional competent to assess a person's decision to hasten death?

As the country continues to debate the legality of aid-in-dying, it appears inevitable that at some point there will be a need for mental health professionals to be involved in assessments of individuals asking for a hastened death. I designed this article to provide a set of guidelines that will allow both mental health professionals and potential consultees to determine if a professional has the training and expertise necessary to be a competent consultant.

Attitude to Death↗
PubMed1999

Mental health professionals and assisted death: perceived ethical obligations and proposed guidelines for practice.

I have three purposes in this article: (a) to briefly review the legal obligations a mental health professional has when working with a client who is talking about taking some action that could lead to his or her death, (b) to clarify the positions of the 4 major national mental health organizations regarding the acceptable roles of their members with clients who are discussing the possibility of receiving assisted death, and (c) to propose a set of guidelines for practice for mental health professionals working with clients who are considering assisted death that comport with the various laws and codes of ethics.

Attitude↗
PubMedDate not supplied

A critical analysis of criticisms of the Oregon Death with Dignity Act.

This article critically examines the validity of common criticisms of the Oregon Death with Dignity Act, primarily through reviewing published research and analyses. After summarizing the law and recent developments, 11 areas of concerns are examined: (a) the amount of data collected, (b) the availability of the data, (c) the reporting process, (d) protection of physicians, (e) terminal illness as a requirement, (f) the amount of data on palliative care interventions, (g) data on lethal prescriptions, (h) data on psychological/psychiatric evaluations, (i) whether the decision to request medication is informed, (j) whether the request is voluntary, and (k) financial factors. The authors examine each of these areas of concern and find criticisms to be unfounded given the research and analyses conducted to date.

Death↗