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May 1, 2008 2 minutes read
'Dr. Death' seeks to become Rep. Kevorkian
The former physician who went to prison as "Dr. Death" in 1999 has announced he will seek election as a Congressman from Michigan. Jack Kevorkian, who was released from prison in 2007 after serving eight years of a 10- to 25-year sentence for second-degree murder, said in announcing his bid for office that he would seek to bolster the 9th amendment, which he claims gives Americans the right to, among other things, assisted suicide.
Kevorkian must gather 3,000 signatures from registered voters by July to win a spot on the November ballot, but being a convicted felon won't restrict him from running for office. The only requirements to run for Congress are age (at least 25) and residency in the state. In announcing his bid for office, Kevorkian said he would run without any party affiliation for the seat, which represents a suburban area of Detroit.
Kevorkian claimed to have assisted in the suicides of more than 130 people between 1990 and 1998, but he was charged and convicted only in the death of Thomas Youk, a California man with Lou Gehrig's disease. A condition of Kevorkian's parole is that he not assist in any more suicides.
Antibiotics and end-of-life in dementia patients
Antibiotics are frequently prescribed to nursing home patients with advanced dementia in nursing homes, posing two potential ethical dilemmas — both in the treatment burden placed on patients at the end of life and the spread of antimicrobial resistance in the nursing home community — a research group reports.
Erika D'Agata, MD, MPH, of Boston's Beth Israel Deaconess Medical Center and Harvard Medical School, led a team that studied 214 residents with advanced dementia living in 21 nursing homes. Each patient was followed up, after an initial review, for up to 18 months; during that time, 99 of the residents died, and of those, 42 (42.4%) received antibiotics during the final two weeks before they died.
"The proportion of residents taking antimicrobials was seven times greater in the last two weeks of life compared with six to eight weeks before death," the authors write. Thirty of the 72 courses (41.7%) in the last two weeks of life were administered intravenously rather than by mouth, a method that may be uncomfortable for patients with advanced dementia.
"This extensive use of antimicrobials and pattern of antimicrobial management in advanced dementia raises concerns not only with respect to individual treatment burden near the end of life but also with respect to the development and spread of antimicrobial resistance in the nursing home setting," the authors write. The results support "the development of programs and guidelines designed to reduce the use of antimicrobial agents in advanced dementia." (D'Agata E, Mitchell SL. Patterns of antimicrobial use among nursing home residents with advanced dementia Arch Intern Med 2008;168:357-362.)
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