An effect of communication on medical decision making: answerability, and the medically induced death of Paul Mills.

In this essay, the occasion of a medically induced death is examined to illustrate how circumstances surrounding a medically induced death are interpreted through a theory of how social agents, on occasion, respond inappropriately. The essay illustrates and assesses an occasion when a health professional, faced with a medical crisis that was laden with professional, ethical, and even legal considerations, responded in a manner that overlooked all those standards when she injected potassium chloride into her patient, Paul Mills. In the essay, the case is chronicled and the character of the social and communicative mechanism that led to the disaster is given and used to interpret the events.

Family conversations about organ donation.

OBJECTIVE: To describe family conversations about organ donation and to examine interrelationships among the content and outcomes of these conversations, and attitudes toward organ donation. DESIGN: Closed and open-ended survey questions. PARTICIPANTS: 353 men and 488 women. MAIN OUTCOME MEASURES: Content analysis of reports of conversations and of reactions of family members to the conversations, as well as closed items assessing both those issues and attitudes toward donation. RESULTS: Most respondents who were willing to donate their organs had not talked with their families about their donation wishes. Conversations that did occur were typically about the patient's donation wishes and moral and altruistic reasons for donation, or included a story about donation. These approaches, as well as talking about the reasons for wishing to donate, were associated with positive responses from family members, whereas discussing fears about being declared dead prematurely or about the medical establishment were associated with negative responses.