{"@context":"http://iiif.io/api/presentation/3/context.json","id":"https://arizona.aviaryplatform.com/iiif/j09w08xd81/manifest","type":"Manifest","label":{"en":["Bioethics"]},"logo":"https://d9jk7wjtjpu5g.cloudfront.net/organizations/logo_images/000/000/038/original/university-libraries-logo-2x.png?1711560609","metadata":[{"label":{"en":["Publisher"]},"value":{"en":["University of Arizona Libraries"]}},{"label":{"en":["Rights Statement"]},"value":{"en":["Copyright held by University of Arizona Libraries"]}},{"label":{"en":["Source"]},"value":{"en":["Arizona Alumni Forum videocassettes, MS 646, box 3, tape 10"]}},{"label":{"en":["Agent"]},"value":{"en":["Iserson, Kenneth V. (interviewee)"]}},{"label":{"en":["Date"]},"value":{"en":["5/2/89"]}},{"label":{"en":["Coverage"]},"value":{"en":["Arizona--Tucson (spatial)"]}},{"label":{"en":["Language"]},"value":{"en":["English"]}},{"label":{"en":["Description"]},"value":{"en":["Guest – Kenneth Iserson."]}},{"label":{"en":["Format"]},"value":{"en":["U-matic"]}},{"label":{"en":["Identifier"]},"value":{"en":["MS646.039 (uid)"]}},{"label":{"en":["Relation"]},"value":{"en":["Arizona Alumni Forum videocassettes (part of)"]}},{"label":{"en":["Type"]},"value":{"en":["Interviews"]}}],"summary":{"en":["Guest – Kenneth Iserson."]},"requiredStatement":{"label":{"en":["Attribution"]},"value":{"en":["Copyright held by University of Arizona Libraries"]}},"provider":[{"id":"https://arizona.aviaryplatform.com/aboutus","type":"Agent","label":{"en":["University of Arizona Libraries"]},"homepage":[{"id":"https://arizona.aviaryplatform.com/","type":"Text","label":{"en":["University of Arizona Libraries"]},"format":"text/html"}],"logo":[{"id":"https://d9jk7wjtjpu5g.cloudfront.net/organizations/logo_images/000/000/038/original/university-libraries-logo-2x.png?1711560609","type":"Image"}]}],"thumbnail":[{"id":"https://d9jk7wjtjpu5g.cloudfront.net/collection_resource_files/thumbnails/000/159/354/small/azu_ms646-039_a.mp4_1651758846.jpg?1651758847","type":"Image","format":"image/jpeg"}],"items":[{"id":"https://arizona.aviaryplatform.com/collections/1078/collection_resources/73601/file/159354","type":"Canvas","label":{"en":["Media File 1 of 1 - azu_ms646-039_a.mp4"]},"duration":1644.61,"width":640,"height":360,"thumbnail":[{"id":"https://d9jk7wjtjpu5g.cloudfront.net/collection_resource_files/thumbnails/000/159/354/small/azu_ms646-039_a.mp4_1651758846.jpg?1651758847","type":"Image","format":"image/jpeg"}],"items":[{"id":"https://arizona.aviaryplatform.com/collections/1078/collection_resources/73601/file/159354/content/1","type":"AnnotationPage","items":[{"id":"https://arizona.aviaryplatform.com/collections/1078/collection_resources/73601/file/159354/content/1/annotation/1","type":"Annotation","motivation":"painting","body":{"id":"https://aviary-p-arizona.s3.wasabisys.com/collection_resource_files/resource_files/000/159/354/original/azu_ms646-039_a.mp4?1651758830","type":"Video","format":"video/mp4","duration":1644.61,"width":640,"height":360},"target":"https://arizona.aviaryplatform.com/collections/1078/collection_resources/73601/file/159354","metadata":[]}]}],"annotations":[{"id":"https://arizona.aviaryplatform.com/collections/1078/collection_resources/73601/file/159354/transcript/37796","type":"AnnotationPage","label":{"en":["ms646-039 [Transcript]"]},"items":[{"id":"https://arizona.aviaryplatform.com/collections/1078/collection_resources/73601/file/159354/transcript/37796/annotation/1","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"UNKNOWN SPEAKER: Hello,","format":"text/plain"},"target":"https://arizona.aviaryplatform.com/collections/1078/collection_resources/73601/file/159354#t=63.0,63.999"},{"id":"https://arizona.aviaryplatform.com/collections/1078/collection_resources/73601/file/159354/transcript/37796/annotation/2","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"UNKNOWN SPEAKER: welcome to Arizona alumni forum. I'm Alan Beagle, Vice President of the University of Arizona, and your host for today's forum. Many of you recently read about a tragic case in Chicago, where a young father, obviously very distressed about his terminally ill son came into a hospital with a gun held all of the nursing and medical staff at bay in order to disconnect the respirator from his son. With me today, as my guest is Dr. Kenneth Iser son of the faculty of the University of Arizona College of Medicine, the Department of Surgery at Arizona Health Sciences Center, and also the chair of the Arizona Health Sciences Center bio ethics committee, a committee which struggles with how to deal with situations such as the recent event in Chicago. Welcome, Dr. Isaacson. Are you doing it? What about the Linares case?","format":"text/plain"},"target":"https://arizona.aviaryplatform.com/collections/1078/collection_resources/73601/file/159354#t=64.0,118.999"},{"id":"https://arizona.aviaryplatform.com/collections/1078/collection_resources/73601/file/159354/transcript/37796/annotation/3","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"UNKNOWN SPEAKER: There's cases sad from several viewpoints. The child from all the reports was essentially brain dead for a long period of time. Yet the hospital teaching hospital was unwilling to take the child off of the ventilator. It seems like that hospital did not have a functioning bioethics committee, whose job at one of the jobs is to review cases, that for the benefit of the family and the patient, and the clinicians, to see whether life support should be withdrawn or withheld, in cases that a terminal in fact, though, if the child was in fact brain dead, there really wasn't a bioethical issue in that case, and the child should have been withdrawn from life support.","format":"text/plain"},"target":"https://arizona.aviaryplatform.com/collections/1078/collection_resources/73601/file/159354#t=119.0,168.999"},{"id":"https://arizona.aviaryplatform.com/collections/1078/collection_resources/73601/file/159354/transcript/37796/annotation/4","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"UNKNOWN SPEAKER: In that case, and other similar cases that we've all read about. It would appear to the perhaps casual reader or viewer that perhaps the hospital is just concerned with the legal implications of what it's doing, and perhaps reluctant to act even in obvious situations, at least to the lay person, because it's afraid it's going to get sued if it does the wrong thing.","format":"text/plain"},"target":"https://arizona.aviaryplatform.com/collections/1078/collection_resources/73601/file/159354#t=169.0,188.999"},{"id":"https://arizona.aviaryplatform.com/collections/1078/collection_resources/73601/file/159354/transcript/37796/annotation/5","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"UNKNOWN SPEAKER: Unfortunately, that is more and more commonly the case with the skyrocketing malpractice situation, the temerity of certain hospitals, and there may have been some value judgments on the part of some of the administrators of this religious space Hospital in Chicago, I was recently in Chicago. And it is very sad what's happening with the family. And in fact, what had happened to a family just prior to that, that it actually had to take the hospital to court to get what the doctor said was a brain dead individual removed from a ventilator","format":"text/plain"},"target":"https://arizona.aviaryplatform.com/collections/1078/collection_resources/73601/file/159354#t=189.0,223.999"},{"id":"https://arizona.aviaryplatform.com/collections/1078/collection_resources/73601/file/159354/transcript/37796/annotation/6","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"UNKNOWN SPEAKER: is your experience is that your experience, both because of what you've seen here in Tucson, and perhaps what you've read about elsewhere that, that a lot of the problems that occur in this area because hospitals and physicians are basically unprepared to deal with the situation.","format":"text/plain"},"target":"https://arizona.aviaryplatform.com/collections/1078/collection_resources/73601/file/159354#t=224.0,240.999"},{"id":"https://arizona.aviaryplatform.com/collections/1078/collection_resources/73601/file/159354/transcript/37796/annotation/7","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"UNKNOWN SPEAKER: That possible. The unfortunate thing in Arizona is that only about three of our 73 acute care hospitals now have bioethics committees that can help clinicians deal with these types of issues. Recently, we've initiated the new Arizona bioethics network, which is essentially in place at least for the first few years to help establish these committees in acute care hospitals in Arizona, help them get started help teach them what to do, so that they can help their clinicians make difficult decisions. physicians in general, have not been trained deeply in ethics. They've been trained deeply, hopefully in medicine. They're no longer the same. They're not the same as when the priest and the physician were the same, same individual in most cases. So they need some people with an interest in bioethics. And usually it's a diverse group to come together and help help them make the best decision, not replace them in decision making but assist them in what may be a difficult process help","format":"text/plain"},"target":"https://arizona.aviaryplatform.com/collections/1078/collection_resources/73601/file/159354#t=241.0,305.999"},{"id":"https://arizona.aviaryplatform.com/collections/1078/collection_resources/73601/file/159354/transcript/37796/annotation/8","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"UNKNOWN SPEAKER: the physician, the patient, if the patient is obviously in a position, which usually isn't. And the family,","format":"text/plain"},"target":"https://arizona.aviaryplatform.com/collections/1078/collection_resources/73601/file/159354#t=306.0,312.999"},{"id":"https://arizona.aviaryplatform.com/collections/1078/collection_resources/73601/file/159354/transcript/37796/annotation/9","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"UNKNOWN SPEAKER: in the family and certainly, at least in part, the institution also","format":"text/plain"},"target":"https://arizona.aviaryplatform.com/collections/1078/collection_resources/73601/file/159354#t=313.0,317.999"},{"id":"https://arizona.aviaryplatform.com/collections/1078/collection_resources/73601/file/159354/transcript/37796/annotation/10","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"UNKNOWN SPEAKER: and the institution also, if the institution is in your view helped by saith, this bioethics committee, why is it then that only three out of 73 Arizona hospitals to date have formed bioethics committees?","format":"text/plain"},"target":"https://arizona.aviaryplatform.com/collections/1078/collection_resources/73601/file/159354#t=318.0,331.999"},{"id":"https://arizona.aviaryplatform.com/collections/1078/collection_resources/73601/file/159354/transcript/37796/annotation/11","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"UNKNOWN SPEAKER: That's like, preaching to the converted. It's difficult to ask someone who has a bioethics committee Why? Why the others? Don't?","format":"text/plain"},"target":"https://arizona.aviaryplatform.com/collections/1078/collection_resources/73601/file/159354#t=332.0,340.999"},{"id":"https://arizona.aviaryplatform.com/collections/1078/collection_resources/73601/file/159354/transcript/37796/annotation/12","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"UNKNOWN SPEAKER: I don't have anybody here.","format":"text/plain"},"target":"https://arizona.aviaryplatform.com/collections/1078/collection_resources/73601/file/159354#t=341.0,342.999"},{"id":"https://arizona.aviaryplatform.com/collections/1078/collection_resources/73601/file/159354/transcript/37796/annotation/13","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"UNKNOWN SPEAKER: That's right. In part in part though, one they don't think that they have people with expertise to they don't think they have people with interest, which is usually both of those are usually incorrect if they go looking for them. Three BIOS ethics committees are actually relatively new. They started out in the mid 70s, more or less, very slowly got a lot of impetus with the Karen and Quinlan case back in New Jersey, where the court in fact, I misunderstood what they were asking for, but suggested that there should be bioethics committees. Arizona has been very slow in developing bioethics committees. There doesn't seem to be interest in some cases in the part of the hospital administration, or in some cases active resistance.","format":"text/plain"},"target":"https://arizona.aviaryplatform.com/collections/1078/collection_resources/73601/file/159354#t=343.0,390.999"},{"id":"https://arizona.aviaryplatform.com/collections/1078/collection_resources/73601/file/159354/transcript/37796/annotation/14","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"UNKNOWN SPEAKER: Well, if a viewer would find themselves as a family member involved in an unfortunate situation, where there is someone who, for whatever reason, a respirator might have to be disconnected or that might be an issue, and a hospital doesn't have a bioethics committee. What should that person do?","format":"text/plain"},"target":"https://arizona.aviaryplatform.com/collections/1078/collection_resources/73601/file/159354#t=391.0,410.999"},{"id":"https://arizona.aviaryplatform.com/collections/1078/collection_resources/73601/file/159354/transcript/37796/annotation/15","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"UNKNOWN SPEAKER: Assuming that they are not in a position where they can discuss it with one, their individual physician or team of physicians, in a reasonable way, they may as an interim measure, try the chaplaincy office, at their hospital. Or else they may be basically, out of luck for that particular situation. Certainly, there's the remedy of going to court that's not usually acceptable, both because of the time involved, and it frequently doesn't solve the real issues. But the chat was the office at least as an interim, maybe, maybe useful.","format":"text/plain"},"target":"https://arizona.aviaryplatform.com/collections/1078/collection_resources/73601/file/159354#t=411.0,449.999"},{"id":"https://arizona.aviaryplatform.com/collections/1078/collection_resources/73601/file/159354/transcript/37796/annotation/16","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"UNKNOWN SPEAKER: When we come back, let's talk a little bit more about the different kinds of situations that some of our viewers may encounter in the future. Okay.","format":"text/plain"},"target":"https://arizona.aviaryplatform.com/collections/1078/collection_resources/73601/file/159354#t=450.0,470.999"},{"id":"https://arizona.aviaryplatform.com/collections/1078/collection_resources/73601/file/159354/transcript/37796/annotation/17","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"UNKNOWN SPEAKER: Welcome back to Arizona alumni forum. I'm Alan Beagle, your host and our guest today is Dr. Ken Iser, son of the Arizona Health Sciences Center, who Among his many responsibilities as chair of the hospital's bio ethics committee, can, there are obviously a lot of different situations that can occur that are troublesome for hospital officials, for physicians who work in the hospital and for family members who encounter them. I'd like to go through a couple of examples of common types of situations that occur and ask you to sort of talk about it not only from the perspective of a physician who works in a hospital, and particularly an emergency department, but also if you want to put yourself in the place of some of the family members who might be coming into the hospital that time and what they encounter and perhaps what they can learn in order to deal with these unfortunate situations.","format":"text/plain"},"target":"https://arizona.aviaryplatform.com/collections/1078/collection_resources/73601/file/159354#t=471.0,521.999"},{"id":"https://arizona.aviaryplatform.com/collections/1078/collection_resources/73601/file/159354/transcript/37796/annotation/18","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"UNKNOWN SPEAKER: First, let's","format":"text/plain"},"target":"https://arizona.aviaryplatform.com/collections/1078/collection_resources/73601/file/159354#t=522.0,523.999"},{"id":"https://arizona.aviaryplatform.com/collections/1078/collection_resources/73601/file/159354/transcript/37796/annotation/19","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"UNKNOWN SPEAKER: take the case of a person who's been at home with a terminal illness or perhaps in a, in a nursing care facility, who for whatever reason, is brought to the hospital, in a coma, having lapsed into that coma prior to being taken to the hospital. person has a known terminal illness. What kind of situation does that present for you and for the family members and for the hospital?","format":"text/plain"},"target":"https://arizona.aviaryplatform.com/collections/1078/collection_resources/73601/file/159354#t=524.0,550.999"},{"id":"https://arizona.aviaryplatform.com/collections/1078/collection_resources/73601/file/159354/transcript/37796/annotation/20","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"UNKNOWN SPEAKER: That's a very difficult situation. And it's right on the forefront of some of the ethical decisions that are having to be made nationally. And statewide right now. The people who are Terminal B they elderly people or young people, it's advised that the physician taking care of them first, talk with a family see if they're willing to let the person die comfortably at home. comfortably, meaning that a physician or home health nurse or another type of medical person would be there to give analgesics painkillers for the person as necessary, but that they would die at home. Frequently they'll have a living will or they'll have a durable power of attorney with medical provisions stating that they don't want advanced life support CPR or other things done. problem comes in. Is it the last moment when there is gasping or person is obviously in their death throes, the family push the panic button, very understandably, especially if they can't at that last moment, get ahold of the clinician and call 911. The typical thing that we're taught to do in emergencies, they call up and they say to the person on the answering the phone, my husband is dying, immediately they're transferred to the paramedic unit, it sent out the EMR system, the emergency medical service system then cannot be stopped. Under the law, the way it works, they have to do for resuscitation. Whether a living wills present or not, they're really not in a position to accept it. They're brought to the emergency room where emergency physicians must continue try to resuscitate the person, often at the rest primary relevant","format":"text/plain"},"target":"https://arizona.aviaryplatform.com/collections/1078/collection_resources/73601/file/159354#t=551.0,651.999"},{"id":"https://arizona.aviaryplatform.com/collections/1078/collection_resources/73601/file/159354/transcript/37796/annotation/21","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"UNKNOWN SPEAKER: backup for a moment because it says something fascinating. I didn't know. You're saying in effect that if a family is involved with a situation where they know there has been some prior arrangement made with the individual who has the terminal illness, that their best bet, if that person lapses into some kind of coma, is to do nothing,","format":"text/plain"},"target":"https://arizona.aviaryplatform.com/collections/1078/collection_resources/73601/file/159354#t=652.0,672.999"},{"id":"https://arizona.aviaryplatform.com/collections/1078/collection_resources/73601/file/159354/transcript/37796/annotation/22","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"UNKNOWN SPEAKER: is to do nothing,","format":"text/plain"},"target":"https://arizona.aviaryplatform.com/collections/1078/collection_resources/73601/file/159354#t=673.0,673.999"},{"id":"https://arizona.aviaryplatform.com/collections/1078/collection_resources/73601/file/159354/transcript/37796/annotation/23","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"UNKNOWN SPEAKER: if they're not to call 911. Right, not to call anybody but basically to do nothing but call the call the personal physician or call the personal physician directly. That's right. Okay, that's okay. But what you're also saying is if they call 911, then regardless of what kind of previous arrangements had been made, they've set in motion a system, which then results in what","format":"text/plain"},"target":"https://arizona.aviaryplatform.com/collections/1078/collection_resources/73601/file/159354#t=674.0,696.999"},{"id":"https://arizona.aviaryplatform.com/collections/1078/collection_resources/73601/file/159354/transcript/37796/annotation/24","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"UNKNOWN SPEAKER: results in a lot of anguish to the family. If for some reason the patient should regained consciousness, certainly, with a tube and breathing for them and other tubes, helping them along anguish to them, a high cost to the medical system, the family back up again, you","format":"text/plain"},"target":"https://arizona.aviaryplatform.com/collections/1078/collection_resources/73601/file/159354#t=697.0,712.999"},{"id":"https://arizona.aviaryplatform.com/collections/1078/collection_resources/73601/file/159354/transcript/37796/annotation/25","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"UNKNOWN SPEAKER: say if the patient should regain consciousness? Yes. I think there are a lot of people who would feel well, then we did the right thing. Obviously, if the person regained consciousness, maybe they weren't yet ready to die. And if so was it would it have been the right thing for the family to have let them die?","format":"text/plain"},"target":"https://arizona.aviaryplatform.com/collections/1078/collection_resources/73601/file/159354#t=713.0,729.999"},{"id":"https://arizona.aviaryplatform.com/collections/1078/collection_resources/73601/file/159354/transcript/37796/annotation/26","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"UNKNOWN SPEAKER: There's a old saying, There is no reason ever for the living to envy the dead. And we can prolong the dying in the agony of a lot of patients with terminal diseases, there is life is a terminal disease, people do die and physicians can postpone it, but they can't stop it. And when a person has a terminal disease, and there is no chance that we can remit it, natural death is a suitable outcome.","format":"text/plain"},"target":"https://arizona.aviaryplatform.com/collections/1078/collection_resources/73601/file/159354#t=730.0,762.999"},{"id":"https://arizona.aviaryplatform.com/collections/1078/collection_resources/73601/file/159354/transcript/37796/annotation/27","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"UNKNOWN SPEAKER: So in parked in a lot of whether this works effectively depends on the kind of counseling and advice that the patient and the family members get when they make the agreement to in a sense, whatever it's called a living will, or whatever it's called, that when that situation occurs, that I described, the agreement has been made, that the patient will be allowed to die, and that everybody needs to be comfortable with that so that the panic button that you describe the so called 911 panic button doesn't get pushed, because as you said before, that puts in motion a chain of events that in the end, everybody ends up regretting, and really to no avail.","format":"text/plain"},"target":"https://arizona.aviaryplatform.com/collections/1078/collection_resources/73601/file/159354#t=763.0,800.999"},{"id":"https://arizona.aviaryplatform.com/collections/1078/collection_resources/73601/file/159354/transcript/37796/annotation/28","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"UNKNOWN SPEAKER: Absolutely. And I should point out that the patient is very often the one who either instigates this type of decision making with the primary physician, the rest of their family, or at least as an integral part.","format":"text/plain"},"target":"https://arizona.aviaryplatform.com/collections/1078/collection_resources/73601/file/159354#t=801.0,812.999"},{"id":"https://arizona.aviaryplatform.com/collections/1078/collection_resources/73601/file/159354/transcript/37796/annotation/29","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"UNKNOWN SPEAKER: When we come back, we'll take up another, if you will, usual clinical situation that calls for bioethical kinds of decisions. Stay tuned with us. We'll be back.","format":"text/plain"},"target":"https://arizona.aviaryplatform.com/collections/1078/collection_resources/73601/file/159354#t=813.0,832.999"},{"id":"https://arizona.aviaryplatform.com/collections/1078/collection_resources/73601/file/159354/transcript/37796/annotation/30","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"UNKNOWN SPEAKER: Welcome back.","format":"text/plain"},"target":"https://arizona.aviaryplatform.com/collections/1078/collection_resources/73601/file/159354#t=833.0,836.999"},{"id":"https://arizona.aviaryplatform.com/collections/1078/collection_resources/73601/file/159354/transcript/37796/annotation/31","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"UNKNOWN SPEAKER: Welcome back to Arizona alumni forum. I'm Alan Beagle, your host and my guest today is Dr. Ken Isaacson, chair of the bioethics committee at the Arizona Health Sciences Center. And we've been talking with Dr. Isaacson about a lot of very distressing situations that do occur because they involve death which occurs to all of us and how they can perhaps be better handled particularly from an ethical situation. Before our last break, can we talked about the person who has a chronic illness and his terminal, like to change the focus in this segment and talk about the situations that you encounter? When someone is brought into the emergency room has been involved in an acute accident, let's say a motorcycle accident or an auto vehicle or accident, and the person is examined by you or one of the other doctors in the emergency room. And the person is basically being resuscitated on artificial means, but is in effect brain dead. No family present in the emergency room family on the way Take us through that what happens? What are the issues,","format":"text/plain"},"target":"https://arizona.aviaryplatform.com/collections/1078/collection_resources/73601/file/159354#t=837.0,902.999"},{"id":"https://arizona.aviaryplatform.com/collections/1078/collection_resources/73601/file/159354/transcript/37796/annotation/32","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"UNKNOWN SPEAKER: very difficult situation again, because nobody believes they're ever going to be involved in that type of disastrous situation, and nobody believes any member of their family will. And yet it does occur, it occurs every day on our city streets and elsewhere. Online, unlike the book coma, we don't immediately look at that individual as an organ donor, and ship them over for spare parts. In fact, except under extremely rare circumstances, where there's just devastating injury to the entire top of the head, we would not declare someone brain dead solely in the emergency department. We resuscitate them as do the paramedics who bring them to us. We resuscitate them as fully as we can. And in fact, there's many types of injuries where we know the people will look brain dead, they won't have any reactivity. In fact, even if we would do an electroencephalogram, a brainwave test on them, during that period of time, it might be flat or almost flat. And yet, they will have a chance of walking out of the hospital. Normally, it could be because of all types of drugs they may have taken or insults to their body, but we treat them whenever possible as a potentially living person, and we do everything necessary to save their life. And this is very reasonable because many of these people do walk out of the hospital. If we have no nothing else, we have to do surgeries to save their life. They're sent to the intensive care unit under intensive therapy. And only after a number of tests to make sure that in fact, there's nothing else causing this apparent brain death. And after an number of hours and a number of physicians have separately and independently examined them. Would we even consider approaching people for organ donation? Okay, but organ donation by itself is a major ethical issue because one young brain dead person can supply Oregon's to save the lives. envision of Mabel,","format":"text/plain"},"target":"https://arizona.aviaryplatform.com/collections/1078/collection_resources/73601/file/159354#t=903.0,1032.999"},{"id":"https://arizona.aviaryplatform.com/collections/1078/collection_resources/73601/file/159354/transcript/37796/annotation/33","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"UNKNOWN SPEAKER: let me back up again. Yeah, I hear what you're saying about taking people to the intensive care unit. What I don't understand is do you do that in every case, where a person comes into the emergency room who appears to have expired? Or is it only in certain types of cases where you do that, where you don't declare a person deceased in the emergency room?","format":"text/plain"},"target":"https://arizona.aviaryplatform.com/collections/1078/collection_resources/73601/file/159354#t=1033.0,1051.999"},{"id":"https://arizona.aviaryplatform.com/collections/1078/collection_resources/73601/file/159354/transcript/37796/annotation/34","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"UNKNOWN SPEAKER: No. If their heart stops, and we can't get it going again, the person is dead.","format":"text/plain"},"target":"https://arizona.aviaryplatform.com/collections/1078/collection_resources/73601/file/159354#t=1052.0,1057.999"},{"id":"https://arizona.aviaryplatform.com/collections/1078/collection_resources/73601/file/159354/transcript/37796/annotation/35","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"UNKNOWN SPEAKER: Okay, so you're talking about people in the emergency room whose heart is continuing to function? That's right. But there is evidence of brain dead. Okay, I want to just to clarify that we weren't talking necessarily about everyone who's brought into an emergency, the vast","format":"text/plain"},"target":"https://arizona.aviaryplatform.com/collections/1078/collection_resources/73601/file/159354#t=1058.0,1069.999"},{"id":"https://arizona.aviaryplatform.com/collections/1078/collection_resources/73601/file/159354/transcript/37796/annotation/36","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"UNKNOWN SPEAKER: the vast majority are the ones who in fact, their heart stops and they're dead in the emergency, they","format":"text/plain"},"target":"https://arizona.aviaryplatform.com/collections/1078/collection_resources/73601/file/159354#t=1070.0,1074.999"},{"id":"https://arizona.aviaryplatform.com/collections/1078/collection_resources/73601/file/159354/transcript/37796/annotation/37","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"UNKNOWN SPEAKER: can't be resuscitated. Okay, now, let's go back to this intensive care unit and the decision path as it were regarding organ transplant, I take it it's true that the majority of people in such situations have not made some prior arrangements for consent to donate their organs, even with our so called organ donor laws. Is that a fair statement?","format":"text/plain"},"target":"https://arizona.aviaryplatform.com/collections/1078/collection_resources/73601/file/159354#t=1075.0,1095.999"},{"id":"https://arizona.aviaryplatform.com/collections/1078/collection_resources/73601/file/159354/transcript/37796/annotation/38","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"UNKNOWN SPEAKER: Well, it really doesn't matter. Because once you're dead, legally, your body isn't yours. And so it's a catch 22 if you're dead, what you wrote on your license, doesn't matter anymore.","format":"text/plain"},"target":"https://arizona.aviaryplatform.com/collections/1078/collection_resources/73601/file/159354#t=1096.0,1107.999"},{"id":"https://arizona.aviaryplatform.com/collections/1078/collection_resources/73601/file/159354/transcript/37796/annotation/39","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"UNKNOWN SPEAKER: But if you wrote something on your license, you're sure you're not telling people not to do that? No,","format":"text/plain"},"target":"https://arizona.aviaryplatform.com/collections/1078/collection_resources/73601/file/159354#t=1108.0,1111.999"},{"id":"https://arizona.aviaryplatform.com/collections/1078/collection_resources/73601/file/159354/transcript/37796/annotation/40","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"UNKNOWN SPEAKER: no, it's suggest to the family, that that's what you wanted.","format":"text/plain"},"target":"https://arizona.aviaryplatform.com/collections/1078/collection_resources/73601/file/159354#t=1112.0,1115.999"},{"id":"https://arizona.aviaryplatform.com/collections/1078/collection_resources/73601/file/159354/transcript/37796/annotation/41","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"UNKNOWN SPEAKER: Okay. But it doesn't necessarily limit the family to donating those organs that are on the license. Is that what you're saying?","format":"text/plain"},"target":"https://arizona.aviaryplatform.com/collections/1078/collection_resources/73601/file/159354#t=1116.0,1121.999"},{"id":"https://arizona.aviaryplatform.com/collections/1078/collection_resources/73601/file/159354/transcript/37796/annotation/42","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"UNKNOWN SPEAKER: Right there. That's not an absolute prescription or prescription. What it does is if the license has been signed, and just for your own sake, in case you may need an organ at some point, you'd want to sign your license so that other people may do it also,","format":"text/plain"},"target":"https://arizona.aviaryplatform.com/collections/1078/collection_resources/73601/file/159354#t=1122.0,1136.999"},{"id":"https://arizona.aviaryplatform.com/collections/1078/collection_resources/73601/file/159354/transcript/37796/annotation/43","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"UNKNOWN SPEAKER: if the license has been signed, which is your individual choice to donate an organ or organs, does the family have any say then whether organs get donated","format":"text/plain"},"target":"https://arizona.aviaryplatform.com/collections/1078/collection_resources/73601/file/159354#t=1137.0,1145.999"},{"id":"https://arizona.aviaryplatform.com/collections/1078/collection_resources/73601/file/159354/transcript/37796/annotation/44","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"UNKNOWN SPEAKER: if they do theirs? legally or not? Nowhere in the country will any physician, any surgeon take organs for transplantation without the next of Kin's permission.","format":"text/plain"},"target":"https://arizona.aviaryplatform.com/collections/1078/collection_resources/73601/file/159354#t=1146.0,1157.999"},{"id":"https://arizona.aviaryplatform.com/collections/1078/collection_resources/73601/file/159354/transcript/37796/annotation/45","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"UNKNOWN SPEAKER: So if again, if I hear you correctly, if you're inclined, as we hope many people are, to sign their driver's license in a way that allows organs to be donated, they'd be well advised to inform their family member of what they've done so that the family member isn't in, if you will, a questionable situation at the time that something tragic might have occurred.","format":"text/plain"},"target":"https://arizona.aviaryplatform.com/collections/1078/collection_resources/73601/file/159354#t=1158.0,1177.999"},{"id":"https://arizona.aviaryplatform.com/collections/1078/collection_resources/73601/file/159354/transcript/37796/annotation/46","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"UNKNOWN SPEAKER: Well, in fact, one of the biggest problems they're brought is brought to the bioethics committee in general. It is related to the fact that people don't discuss major issues of life and death with their families. And if they had, it would solve an awful lot of problem. We've","format":"text/plain"},"target":"https://arizona.aviaryplatform.com/collections/1078/collection_resources/73601/file/159354#t=1178.0,1192.999"},{"id":"https://arizona.aviaryplatform.com/collections/1078/collection_resources/73601/file/159354/transcript/37796/annotation/47","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"UNKNOWN SPEAKER: got to take a break, Ken All right. We'll be back with our listeners. All of you. Stay tuned and we'll learn some more from Dr. Ken Listen, thank you very much. Stay tuned.","format":"text/plain"},"target":"https://arizona.aviaryplatform.com/collections/1078/collection_resources/73601/file/159354#t=1193.0,1214.999"},{"id":"https://arizona.aviaryplatform.com/collections/1078/collection_resources/73601/file/159354/transcript/37796/annotation/48","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"UNKNOWN SPEAKER: Welcome back to Arizona.","format":"text/plain"},"target":"https://arizona.aviaryplatform.com/collections/1078/collection_resources/73601/file/159354#t=1215.0,1217.999"},{"id":"https://arizona.aviaryplatform.com/collections/1078/collection_resources/73601/file/159354/transcript/37796/annotation/49","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"UNKNOWN SPEAKER: Welcome back to Arizona alumni forum. I'm Alan Beagle, your host. And when we left, we were talking with Dr. Ken Isaacson about some of the situations that physicians in our hospitals and families who have loved ones in the hospitals often encounter. In acute and often tragic circumstances, we were talking about the owner, organ donor potential situation, a family, let's say, has had someone who has just died. And whether or not the person left a organ donor card or not, is, as you pointed out, maybe not the whole story. But the family members themselves are uncertain about the ethics or appropriateness of approving organ donation. And yet over here is a physician or two, who is basically saying to them, you know, your loved one who's just passed away can make a useful contribution by you allowing us to have one or more of that person's organs. What role can a bioethics committee such as the one that you're involved with play in helping that kind of family member to reach some appropriate decision that they're comfortable with?","format":"text/plain"},"target":"https://arizona.aviaryplatform.com/collections/1078/collection_resources/73601/file/159354#t=1218.0,1288.999"},{"id":"https://arizona.aviaryplatform.com/collections/1078/collection_resources/73601/file/159354/transcript/37796/annotation/50","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"UNKNOWN SPEAKER: Well, usually the ethics committee as a whole wouldn't be dealing with these folks. But some of our members might. The issues involved for the individuals are some cultural biases, in some cases, religious biases, and just things that they've read, and maybe some uncertainty about what really goes on and how well their loved one will be treated, even though they are an organ donor.","format":"text/plain"},"target":"https://arizona.aviaryplatform.com/collections/1078/collection_resources/73601/file/159354#t=1289.0,1317.999"},{"id":"https://arizona.aviaryplatform.com/collections/1078/collection_resources/73601/file/159354/transcript/37796/annotation/51","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"UNKNOWN SPEAKER: If a hospital has a bioethics committee, and that person is called or a member of that team is called family member may not even know that one exists. But if that person is called, is that person coming into the situation with the bias of trying to help the family member make the decision to approve the donation of the organ? Or are they coming in with, if you will, the role to help the family member work through whatever their thoughts are about the matter to a comfortable decision?","format":"text/plain"},"target":"https://arizona.aviaryplatform.com/collections/1078/collection_resources/73601/file/159354#t=1318.0,1344.999"},{"id":"https://arizona.aviaryplatform.com/collections/1078/collection_resources/73601/file/159354/transcript/37796/annotation/52","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"UNKNOWN SPEAKER: Well, in fact, if a member of the ethics committee is brought in, then they're there to help the family. But in general, it's through the organ donor bank, or the people who actually contact the family and have a set procedure to explain to them what's going on and follow through the actual procedures. But many of the members of our bioethics committee, in fact, some serve many roles, we not only have physicians on there, we have chaplains, we have bioethicists, who are PhD biosynthesis. We have lay members of the committee, we have some clergy. And in fact, in one case, one of our clergy is also a physician clergy. We have a lawyer who happens to also be a public member. So many of our people wear multiple hats and conserve in multiple roles in serving patients.","format":"text/plain"},"target":"https://arizona.aviaryplatform.com/collections/1078/collection_resources/73601/file/159354#t=1345.0,1398.999"},{"id":"https://arizona.aviaryplatform.com/collections/1078/collection_resources/73601/file/159354/transcript/37796/annotation/53","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"UNKNOWN SPEAKER: So how frequent is it? Is it that at Arizona Health Science Center, one member of your bioethics committee is called into an actual clinical situation to assist with its resolution?","format":"text/plain"},"target":"https://arizona.aviaryplatform.com/collections/1078/collection_resources/73601/file/159354#t=1399.0,1409.999"},{"id":"https://arizona.aviaryplatform.com/collections/1078/collection_resources/73601/file/159354/transcript/37796/annotation/54","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"UNKNOWN SPEAKER: Well, what we call curbside Curbside Consult. Our ethics committee members are known by the staff. The nurses are up on their unit all the time we have to nursing members and are frequently called either by phone or stopped in person to render some consultations, some ideas to help clinicians or nurses or families on their way in ethical problems. But if it's beyond them, and it frequently is, then we have the committee meet on a rather urgent basis. To go through the problems.","format":"text/plain"},"target":"https://arizona.aviaryplatform.com/collections/1078/collection_resources/73601/file/159354#t=1410.0,1447.999"},{"id":"https://arizona.aviaryplatform.com/collections/1078/collection_resources/73601/file/159354/transcript/37796/annotation/55","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"UNKNOWN SPEAKER: We've talked today. In a limited time, we've had mostly about situations involving death, either the acute situation, or the more chronic situation where there has been an opportunity to prepare. But there are also bioethical situations that involve life. And I'm thinking in particular, of situations that we hear about perhaps not in our hospital but elsewhere, or related to genetics and genetic engineering related to birth defects and things of that nature. Can you just tell us in a few seconds, we have left a little bit about what you see in the future, for bioethics in that regard?","format":"text/plain"},"target":"https://arizona.aviaryplatform.com/collections/1078/collection_resources/73601/file/159354#t=1448.0,1483.999"},{"id":"https://arizona.aviaryplatform.com/collections/1078/collection_resources/73601/file/159354/transcript/37796/annotation/56","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"UNKNOWN SPEAKER: Well, one of the hottest issues and in fact, NIH has just said to go ahead with some of it is the issue of fetal transplantation, which has the potential of wiping out Parkinson's disease, Alzheimers disease, juvenile onset diabetes, and yet has a lot of basic health. ethical problems associated with it, which has been recognized. That's just one of the real hot issues.","format":"text/plain"},"target":"https://arizona.aviaryplatform.com/collections/1078/collection_resources/73601/file/159354#t=1484.0,1504.999"},{"id":"https://arizona.aviaryplatform.com/collections/1078/collection_resources/73601/file/159354/transcript/37796/annotation/57","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"UNKNOWN SPEAKER: And, you know, perhaps in a brief sentence or two for our listeners who just minds were just boggled by the notion of fetal transplantation, plant transplantation. What is it and what's the ethical issue.","format":"text/plain"},"target":"https://arizona.aviaryplatform.com/collections/1078/collection_resources/73601/file/159354#t=1505.0,1515.999"},{"id":"https://arizona.aviaryplatform.com/collections/1078/collection_resources/73601/file/159354/transcript/37796/annotation/58","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"UNKNOWN SPEAKER: fetal transplantation is taking brain cells, undeveloped brain cells from a aborted fetus, from whatever reason, putting them into the brain of someone with the Alzheimer's or Parkinson's disease, they regrow because they're able to regrow and regenerate part of the brain that's been lost, and put the person back to essentially normal state.","format":"text/plain"},"target":"https://arizona.aviaryplatform.com/collections/1078/collection_resources/73601/file/159354#t=1516.0,1538.999"},{"id":"https://arizona.aviaryplatform.com/collections/1078/collection_resources/73601/file/159354/transcript/37796/annotation/59","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"UNKNOWN SPEAKER: Well, Dr. Canisius, and I thank you very much for coming. You and your bioethics committee are obviously operating on the frontier of American medicine. And we're going to have to have you come back in order to perhaps spend more time talking about some of these, obviously, important ethical issues, and particularly one that sounds like it's going to be with us for quite a while to come, namely that involved with genetics and genetic engineering. Thank you for joining us today on Arizona alumni forum. I'm Alan Beagle, your host and it's been a pleasure to be with you. Tune in again.","format":"text/plain"},"target":"https://arizona.aviaryplatform.com/collections/1078/collection_resources/73601/file/159354#t=1539.0,1541.0"}]},{"id":"https://arizona.aviaryplatform.com/collections/1078/collection_resources/73601/file/159354/transcript/37796","type":"AnnotationPage","label":{"en":["English [Transcript]"]},"items":[{"id":"https://arizona.aviaryplatform.com/collections/1078/collection_resources/73601/file/159354/transcript/37796/annotation/60","type":"Annotation","motivation":"subtitling","body":{"type":"TextualBody","value":"https://d9jk7wjtjpu5g.cloudfront.net/file_transcripts/associated_files/000/037/796/original/azu_ms646-039_a.vtt?1652899296","format":"text/vtt","language":"en"},"target":"https://d9jk7wjtjpu5g.cloudfront.net/file_transcripts/associated_files/000/037/796/original/azu_ms646-039_a.vtt?1652899296"}]}]}]}