AboutPaul D. Friedman, M.A., Ph.D., J.D. Expertise I have a master's degree in bioethics which inlcudes medical and research ethics. In addition to a law degree, I have a doctorate of philosophy in comparative ethics involving medicine, law and business. I also am an Adjunct Professor at a medical school.
I can answer questions related to the ethics of withholding, instituting or withdrawal of life support.
Experience Experience in the area I have been a practicing trial attorney since 1989 plus I have a master's degree in bioethics and a doctorate of philosophy regarding comparative ethics. I am also an Adjunct Professor at a medical school where I teach current providers and students medical ethics.
Organizations State Bar of Arizona
State Bar of Colorado (inactive)
District of Columbia Bar (inactive)
Federal Bar
Licensed in Arizona District Court
Licensed in Ninth Circuit Court of Appeals
Licensed in the United States Supreme Court American Bar Association National Board of Trial Advocacy
American Association for Justice
Arizona Trial Lawyers Association
American Society for Bioethics and Humanities Kennedy Institute of Ethics National Association of Realtors
Education/Credentials Bachelor of Arts 1985
Juris Doctorate 1989
Master of Arts in Bioethics 2004 Doctorate of Philosphy 2006
Awards and Honors Phi Beta Kappa
Multiple Who's Who
Publications A list of my copyrighted publications and presentations is contained at WWW.EXPERTETHICS.COM
Question My mum took my dad to the doctors in August 08 because of her concern about his confusion etc. They did a battery of tests and discovered he had Prostate cancer (with a PSA of 33). Mid November my mum was diagnosed with a fractured hip and had to go into hospital for a hip replacement op. which went well thankfully. A week to the day of my mum's op. (25th November 08)we had to get an ambulance for dad as we thought he was having a heart attack. It turned out to be a perforated ulcer and immediate surgery was necessary. He then went into post op psychosis or an 'acute confusional state' and was bad enough for the ward he was on to refer him to the Mental Health Unit where his condition has got worse (doesn't recognise his grandchildren - but does recognise his children). The psychiatrist says he has been having TIA's and has vascular dementia. He will need to go into a nursing home they have said as my mum is still very frail as a result of the hip replacement. The Unit have just informed us that his PSA levels are now at 49. Nobody seems to take responsibility for his overall care and we just don't know how long he has left - a bone scan in October showed that the cancer hadn't spread to his bones. Physically he looks quite well although he's lost a lot of weight but mentally he is deteriorating everyday. What can we expect for him? Nobody seems to want to commit to anything or take responsibility for his overall care?
I hope you can shed some light on this. Luckily there are four siblings to share the burden but it is still very hard.
Thank you
Sue
Answer Sue,
I am sorry to hear about your father and wish your mother a speedy recovery.
Nobody can answer your question completely but your family can and should act as your father's advocate. His PSA increasing is a sign that his cancer is becoming more prolific. He should have an oncologist and/or urologist that is in charge of his cancer. It is important to attempt and control the cancer before it spreads into a different organ and becomes a stage IV cancer. Once this occurs, the prognosis is much worse.
As far as your father's dementia, it sounds as if there are other factors. The TIAs are like little strokes which may be causing or exacerbating his dementia. He should have a neurologist and/or internist who is in charge of this condition. There is no way to know the prognosis of the dementia or whether your father is going to have a significant stroke but they should be conducting diagnostics to determine the extent and etiology of the vascular disease.
It is hard for the family to watch their parents go through life-altering problems. You sound very supportive and this is what they need. Enjoy your time with them because we all have an end and need family support as we get closer to that end.
