"The Last Hospice"

Take a look at this wonderful reflection by Maitri Hospice volunteer Lisa Katayama at Boing Boing.

"Frank Talk About Care at Life’s End"

This from The New York Times...

Legislators have begun to recognize the medical, humanitarian and economic value of helping terminally ill patients and their families navigate treatment options as they approach the end of life.

Last week, over the objections of New York State’s medical society, Gov. David A. Paterson signed into law a bill — the New York Palliative Care Information Act — requiring physicians who treat patients with a terminal illness or condition to offer them or their representatives information about prognosis and options for end-of-life care, including aggressive pain management and hospice care as well as the possibilities for further life-sustaining treatment.

The Medical Society of the State of New York objected, saying that the new law would intrude “unnecessarily upon the physician-patient relationship” and mandate “a legislatively designed standard of care.”

A similar provision in the original federal health care overhaul proposal, which would have reimbursed doctors for the time it takes to have such conversations, was withdrawn when it was erroneously labeled by conservatives as a “death panel” option.

Also last week, a study in The New England Journal of Medicine reported that among 151 patients with newly diagnosed metastatic lung cancer, those who received palliative care, which is care focused on symptoms, along with standard cancer therapy had a better quality of life, experienced less depression, were less likely to receive aggressive end-of-life care and lived nearly three months longer than those who received cancer treatment alone.

The New York law was sponsored by Assemblyman Richard N. Gottfried and Senator Thomas K. Duane, both Democrats of Manhattan, at the request of Compassion and Choices of New York, an organization that seeks to improve end-of-life comfort care and reduce the agony often associated with dying in this era of costly can-do medicine.

The organization said the law addresses “a major concern for terminally ill patients and their families, who often face the most important decision of their lives — how to live their final days — without being informed of their legal rights and medical options.” The law obligates health care providers to volunteer information on a complete menu of care options — if patients want to know about the options.

A Buddhist Wedding Service...

...Courtesy of our past interviewee, the Rev. James Ishmael Ford (Zeno Myoun, Roshi), at his excellent blog Monkey Mind.

"Rabbi's Beard Doesn't Make the Cut"

This from The Wall Street Journal...

Rabbi Menachem Stern's stringy brown beard is hardly an unusual sight in his Brooklyn neighborhood. But in trying to become a chaplain in the U.S. Army, Mr. Stern has gotten tangled in a military bureaucracy that has made exceptions for other beards, but not his.

The 28-year-old rabbi was notified last year that he had been accepted as a chaplain in the Army Reserve.

Almost immediately, Army officials contacted him to say the acceptance was a clerical mistake, and that unless he was willing to shave his beard, he couldn't join.

As a Chabad Lubavitch rabbi, Mr. Stern refused, saying the beard is a tenet of his faith.

For nearly a year now, the Crown Heights resident has been trying to get a waiver to the regulation barring beards.

...The Army, whose grooming rules allow only trim, tidy moustaches, has granted exemptions in the past, as recently as this year, when it allowed a Sikh dentist to serve with a beard and turban.

Mr. Stern is getting political support from New York Sen. Kirsten Gillibrand, a Democrat who has urged Army Secretary John McHugh to let him serve, arguing that "no American should have to choose between his religion and service to our country."

Army spokesman George Wright said for those entering the service, "current policy on beards precludes his commissioning as an officer and becoming a member of the Chaplain's Corps."

Mr. Wright wouldn't address the case of the Sikh dentist, but some of Mr. Stern's supporters say the Army has told them the exception was made for him because he had already been training at government expense.

Army regulation 670-1 states that "males will keep their face clean-shaven when in uniform or in civilian clothes on duty," and that "handlebar mustaches, goatees, and beards are not authorized."

Mr. Wright said the regulation is currently under review. Another section of Army policy allows those granted exceptions to the beard rule before 1986 to keep them.

...Today, there is still one section of the U.S. military that's frequently bearded: Special Forces.

Working in hot spots such as Afghanistan, many members of those elite units grow beards to make themselves less conspicuous to locals.

Something to Pay Attention To...

From The Washington Post...

As the number of Muslims in the Virginia prison system has grown to an estimated 2,200, the state has come to lean increasingly on volunteer Muslim chaplains...

But the relationship between the Virginia Department of Corrections and minority faith leaders has long been mired in one of the state's most glaring anachronisms.

Because of a 200-year-old interpretation of the state constitution that bars Virginia from doing any faith-based hiring, it is the only state where prison chaplains are contractors, not state employees. And until last year, the department maintained contracts only with Protestant chaplains. Catholic, Jewish and Muslim chaplains could visit correctional facilities to minister to Virginia's 32,000 inmates, but they received no funds from the state.

"Palliative Care Extends Life, Study Finds"

The New York Times has the story.

In a study that sheds new light on the effects of end-of-life care, doctors have found that patients with terminal lung cancer who began receiving palliative care immediately upon diagnosis not only were happier, more mobile and in less pain as the end neared — but they also lived nearly three months longer.

The findings, published online Wednesday by The New England Journal of Medicine, confirmed what palliative care specialists had long suspected. The study also, experts said, cast doubt on the decision to strike end-of-life provisions from the health care overhaul passed last year.