whos Internet rallies to support teen whose rock museum was burglarized By www.mnn.com Published On :: Thu, 22 Mar 2018 14:37:22 +0000 Judah Tyreman lost rocks and fossils worth thousands, but thanks to the Internet, he'll replace them and even add some more. Full Article Responsible Living
whos 14 luminaries whose work was initially rejected By www.mnn.com Published On :: Mon, 16 Nov 2015 11:49:00 +0000 From Michael Jordan to J.K. Rowling, these superstars prove the value of perseverance. Full Article Green Workplace
whos Whose Site is it Anyway? By www.articlegeek.com Published On :: I spend a lot of time emailing with online business owners. Since that's my specialty, I find a lot of people asking me questions about my success. What amazes me is that many of those people are asking the wrong questions! Full Article
whos Ali Payani - A Young Entrepreneur Whose New Invention Can Save Lives and Millions of Dollars By www.24-7pressrelease.com Published On :: Wed, 07 Jun 2017 07:00:00 GMT A creative and forward thinking inventor Ali Payani is about to launch a revolutionary new air quality measuring technology that will help save lives using Artificial Intelligence (AI). Full Article
whos Sovereign perpetual bonds: An idea whose time has come By economictimes.indiatimes.com Published On :: 2020-05-05T15:12:44+05:30 Perpetual bonds are a standard instrument in the kitty of capital markets today. Full Article
whos Rangers Identify Woman Whose Body was Recovered from below South Rim of Grand Canyon By www.nps.gov Published On :: Wed, 02 May 2012 12:33:00 EST https://www.nps.gov/grca/learn/news/2012-05-02_ident.htm Full Article
whos Mum whose tot has CF 'delighted' with EU first on treatment drug By www.belfastlive.co.uk Published On :: Fri, 8 May 2020 21:08:54 +0000 Kalydeco is the first medicine in Europe to treat the underlying cause of the disease Full Article News
whos Nonhuman mammal whose mtDNA is from a nonhuman mammal resistant to a selected disease or disorder and whose nDNA is from a nonhuman donor mammal more susceptible to the selected disease or disorder By www.freepatentsonline.com Published On :: Tue, 26 May 2015 08:00:00 EDT Provided herein are mitochondrial-nuclear exchanged cells and animals comprising mitochondrial DNA (mtDNA) from one subject and nuclear DNA (nDNA) from a different subject. Methods for producing a mitochondrial-nuclear exchanged animal and animals made by the methods are provided. Also provided are methods of screening for agents useful for treating a disease or disorder using mitochondrial-nuclear exchanged animals or cells, tissues or organs thereof. Full Article
whos Harvested crop residue chopper and distribution arrangement for a combine with an impeller blower whose shape conforms to the contour of the straw chopper By www.freepatentsonline.com Published On :: Tue, 21 Oct 2014 08:00:00 EDT The invention concerns a harvested crop residue chopper and distribution arrangement for a combine (10) with a straw chopper (60) with a rotor (74) that can be brought into rotation about a horizontal axis (98) with chopper blades (76) fastened thereto that define an outer envelope (96), and with at least one impeller blower (82) arranged downstream of the straw chopper (60) with impeller blades (84) that can rotate about an axis of rotation (88) that extends vertically, in which the impeller blades (84) are provided with outer edges (94) that conform to the envelope (96) of the chopper knives (76) and follow it very closely and are not in contact with it. Full Article
whos Carole Rae Woodmansee, whose life centered on family, faith and music, dies at 81 of coronavirus complications By www.seattletimes.com Published On :: Sat, 25 Apr 2020 17:00:48 -0700 Carole Rae Woodmansee, whose life was filled with family, church service and song, died March 27 — her 81st birthday. Full Article Classical Music Entertainment Health Local News Music Northwest Obituaries
whos Carole Rae Woodmansee, whose life centered on family, faith and music, dies at 81 of coronavirus complications By www.seattletimes.com Published On :: Sat, 25 Apr 2020 17:00:48 -0700 Carole Rae Woodmansee, whose life was filled with family, church service and song, died March 27 — her 81st birthday. Full Article Classical Music Entertainment Health Local News Music Northwest Obituaries
whos Hobart principal says school only open for students whose parents have 'no other option' By www.abc.net.au Published On :: Sun, 03 May 2020 18:33:09 +1000 A Catholic college principal tells parents children missing their friends and parents needing time are not valid reasons to send children to school, as Tasmania records its third consecutive day without new coronavirus cases. Full Article COVID-19 Diseases and Disorders Catholic Education Health
whos Valmai Birch, whose body was found in wheelie bin in her home, died while hogtied, court hears By www.abc.net.au Published On :: Tue, 01 Oct 2019 20:26:00 +1000 A man charged with the manslaughter of Valmai Birch, 34, at her NSW south coast home eight years ago is accused of hogtieing her and causing her death by asphyxiation or other means, before putting her body in a wheelie bin. Full Article ABC Illawarra illawarra Law Crime and Justice:All:All Law Crime and Justice:Crime:All Law Crime and Justice:Police:All Australia:NSW:Kiama 2533 Australia:NSW:Wollongong 2500 Australia:NSW:Woonona 2517
whos SA Police officer whose car struck teen motorcyclist has driving conviction overturned By www.abc.net.au Published On :: Sat, 26 Oct 2019 00:08:00 +1100 A police officer who accidentally hit the accelerator instead of the brake during a traffic stop, leaving a boy with multiple broken bones, has an aggravated driving conviction overturned. Full Article ABC Radio Adelaide adelaide Disasters and Accidents:Accidents:All Disasters and Accidents:Accidents:Road Law Crime and Justice:All:All Law Crime and Justice:Courts and Trials:All Law Crime and Justice:Crime:All Law Crime and Justice:Police:All Australia:All:All Australia:SA:Adelaide 5000 Australia:SA:All Australia:SA:Parafield 5106 Australia:SA:Parafield Gardens 5107
whos Police identify woman whose body was found in Melbourne park By www.abc.net.au Published On :: Sun, 26 May 2019 13:54:00 +1000 Victoria Police have identified the woman whose body was found in a park in Melbourne's inner-north as Courtney Herron, a 25-year-old woman of no fixed address. Full Article ABC Local melbourne Community and Society:Homelessness:All Law Crime and Justice:Crime:All Law Crime and Justice:Crime:Murder and Manslaughter Australia:VIC:Parkville 3052
whos Accused Terowie murderer admits to killing relative whose bones were found in fireplace By www.abc.net.au Published On :: Wed, 07 Aug 2019 14:20:00 +1000 A man pleads guilty to killing a relative whose bones were found in a fireplace of a home in South Australia's Mid North eight years after the man went missing. Full Article 639 ABC North and West adelaide northandwest Law Crime and Justice:All:All Law Crime and Justice:Crime:All Law Crime and Justice:Crime:Murder and Manslaughter Law Crime and Justice:Police:All Australia:SA:Adelaide 5000 Australia:SA:All Australia:SA:Terowie 5421
whos Police find teenage mother of newborn whose body was found in Newcastle backyard By www.abc.net.au Published On :: Fri, 21 Jun 2019 17:28:00 +1000 The 18-year-old mother of a newborn baby boy whose body was found in a backyard on Tuesday has been found in Penrith and taken to hospital. Full Article 1233 ABC Newcastle newcastle sydney Community and Society:Death:All Community and Society:Family and Children:Babies - Newborns Community and Society:Welfare:All Health:Women's Health:All Law Crime and Justice:Police:All Australia:NSW:All Australia:NSW:Newcastle 2300 Australia:NSW:Penrith 2750 Australia:NSW:Stockton 2295 Australia:NSW:Waratah 2298
whos Whose Wedding Dress is This By www.bet.com Published On :: Tue, 27 Sep 2016 16:38:00 EDT Can we talk about these wedding dresses though? Full Article Real Husbands of Hollywood
whos #83: Cover Art or Whose Soul Is It Anyway By feedproxy.google.com Published On :: Wed, 28 Mar 2007 16:00:00 +0000 Full Article
whos Dad throws 1-year-old daughter off ‘steep cliff’ into ravine, killing baby whose ‘smile was contagious’ By www.nydailynews.com Published On :: Thu, 07 May 2020 21:44:50 +0000 A California dad allegedly tossed his baby daughter off a “steep cliff” to her death after he stabbed the child’s mom and a bystander who tried to help, relatives and police said. Full Article
whos Knife-wielding straphanger slashes face of woman whose child vomited on Brooklyn bus By www.nydailynews.com Published On :: Thu, 30 Jan 2020 20:08:25 +0000 A Brooklyn woman was slashed in the face with a knife by an enraged passenger after her child threw up on a city bus. Full Article
whos Brooklyn man whose murder conviction was overturned will be retried for 1992 killing By www.nydailynews.com Published On :: Fri, 06 Mar 2020 23:09:26 +0000 Emmanuelle Cooper, 54, spent 27 years in prison for the 1992 murder of MTA employee Andres Barretto, who was fatally shot in an East New York subway station after two men forced their way into a booth and robbed the token clerks inside. Full Article
whos Dad throws 1-year-old daughter off ‘steep cliff’ into ravine, killing baby whose ‘smile was contagious’ By www.nydailynews.com Published On :: Thu, 07 May 2020 21:44:50 +0000 A California dad allegedly tossed his baby daughter off a “steep cliff” to her death after he stabbed the child’s mom and a bystander who tried to help, relatives and police said. Full Article
whos Beverly Cassirer, whose family demanded return of $30-million painting looted by Nazis, dies waiting By www.latimes.com Published On :: Fri, 21 Feb 2020 14:52:03 -0500 The painting of a Parisian street scene by Impressionist master Camille Pissarro hangs in a Madrid museum and is the focus of an ongoing legal battle. Full Article
whos Darius Swann, whose fight to enroll his son led to school integration in N.C., dies at 95 By www.latimes.com Published On :: Fri, 27 Mar 2020 15:07:43 -0400 His fight to enroll his son in a largely white school sparked the use of busing as a means of desegregation Full Article
whos ‘Black Widow’ trailer gives us a fallen Avenger whose origin story is very much alive By www.washingtonpost.com Published On :: Tue, 03 Dec 2019 15:46:26 +0000 Scarlett Johansson is back for a solo movie, coming out May 1, 2020. Full Article
whos Case Study: A Patient With Uncontrolled Type 2 Diabetes and Complex Comorbidities Whose Diabetes Care Is Managed by an Advanced Practice Nurse By spectrum.diabetesjournals.org Published On :: 2003-01-01 Geralyn SpollettJan 1, 2003; 16:Case Studies Full Article
whos Whose story is this? : old conflicts, new chapters / Rebecca Solnit. By www.catalog.slsa.sa.gov.au Published On :: American essays -- 21st century. Full Article
whos Cruz gets his hair cut at salon whose owner was jailed for defying Texas coronavirus restrictions By news.yahoo.com Published On :: Fri, 08 May 2020 19:28:43 -0400 After his haircut, Sen. Ted Cruz said, "It was ridiculous to see somebody sentenced to seven days in jail for cutting hair." Full Article
whos Obituary: Brian Dennehy, imposing actor whose range spanned grizzled cops and Willy Loman By www.heraldscotland.com Published On :: Thu, 30 Apr 2020 05:03:51 +0100 Born: July 9, 1938; Full Article
whos Obituary: Alan Gray: A man whose veins ran with whisky By www.heraldscotland.com Published On :: Thu, 07 May 2020 05:04:02 +0100 Alan Gray – An Appreciation Full Article
whos Patients of Sussex County Doctor Whose Medical License, Controlled Substance Registration Revoked Getting Resources By news.delaware.gov Published On :: Thu, 09 May 2019 22:10:00 +0000 DOVER (May 9, 2019) – On May 8, 2019, the medical license and controlled substance registrations of Nihar B. Gala, MD, were permanently revoked by the Delaware Board of Medical Licensure and Discipline. The revocation was a result of allegations of unprofessional conduct related to the prescription of opioids to a patient at high risk […] Full Article Delaware Health and Social Services Department of State Division of Public Health News Sussex County controlled substance registration Dr. Nihar B. Gala DSAMH HelpIsHereDE.com medical license Mobile Crisis prescriber revoked
whos Patients of NCCo Doctor Whose Medical License, Controlled Substance Registration Suspended Urged to Seek Ongoing Care By news.delaware.gov Published On :: Thu, 01 Aug 2019 15:16:42 +0000 DOVER (Aug. 1, 2019) – On July 30, 2019, the medical license and controlled substance registration of Damon Cary, MD, were suspended temporarily by the Delaware Board of Medical Licensure and Discipline. The suspension was the result of a request made by the Delaware Attorney General’s Office following investigations into the prescribing and treatment practices […] Full Article Delaware Health and Social Services Department of State Division of Public Health benziodiazepine withdrawal Damon Cary HelpIsHereDE.com medical license medical practice opioid withdrawal patients
whos Senior Night: Celebrating NCAA athletes whose seasons were cut short By www.espn.com Published On :: Fri, 8 May 2020 08:40:34 EST The entire sports world was put on hold amid the coronavirus pandemic, leaving college seniors to ask, "What if?" Full Article
whos Mozilla's Firefox 70 Is Out: Privacy Reports Reveal Whose Cookies Are Tracking You By packetstormsecurity.com Published On :: Wed, 23 Oct 2019 18:24:33 GMT Full Article headline privacy spyware mozilla
whos Whose Fault Is Our Temptation? A By feeds.gty.org Published On :: Wed, 19 Feb 2020 00:00:00 PST Full Article
whos Whose Fault Is Our Temptation? B By feeds.gty.org Published On :: Thu, 20 Feb 2020 00:00:00 PST Full Article
whos Whose Fault Is Our Temptation? By feeds.gty.org Published On :: Wed, 22 Apr 2020 00:00:00 PST Full Article
whos On Whose Door Is Christ Knocking? By feeds.gty.org Published On :: Wed, 17 Jul 2019 00:00:00 PST In the lead-up to the Truth Matters conference in October, we will be focusing our attention on the sufficiency, authority, and clarity of Scripture. Of our previous blog series, none better embodies that emphasis than Frequently Abused Verses. The following entry from that series originally appeared on October 5, 2015. -ed. Is it really “abuse” if a verse is used inaccurately to make an important point? The short answer is, “Yes.” We should not be so careless and cavalier with Scripture, or think so highly of ourselves, that we can impose new meaning—even if it is valid—on the inerrant, sufficient Word of God. If the point is worth making, it’s worth making from the appropriate text. Which brings us to the verse before us today: Revelation 3:20 is certainly one of the most familiar and frequently-quoted verses in the church. It’s a particular favorite for evangelists, camp preachers, and anyone else who wants to lend some urgency to the call of God on a sinner’s life “Behold, I stand at the door and knock; if anyone hears My voice and opens the door, I will come in to him and will dine with him, and he with Me” (Revelation 3:20). In the hands of many preachers and evangelists, the verse paints an attractive, compelling picture of Christ’s pursuit of the sinner, and highlights the need for an immediate response. But is that an accurate interpretation of the verse—is Christ truly at the doorstep of each sinner’s heart, pleading to come in? And if not, on whose door is the Lord knocking? Let’s tackle those issues one at a time. Is Christ Knocking? We use a lot of clichés as shorthand in the church, and not all of them are helpful or even accurate. For example, many Christians talk about “asking Jesus into your heart.” And while that phrase might have some vaguely biblical underpinnings, it doesn’t shed any light on what it truly means to repent and believe. If anything, it muddles the sinner’s responsibility in salvation; it dulls some of the sharp edges of the gospel. In the same way, the common misapplication of Revelation 3:20 has done more harm than good. Yes, the mental image of Christ knocking on the door of a sinner’s heart is moving. But it’s not accurate—it’s a caricature at best, and it comes at a high theological cost. Put simply, Christ isn’t pleading on every sinner’s spiritual doorstep. Jesus doesn’t need to beg or badger anyone into the kingdom of heaven (John 10:27-28). Salvation isn’t merely a matter of the Lord getting a foot inside the door of your heart—it’s a work of total transformation (Ezekiel 36:26). And most important of all, salvation is not triggered by an act of the sinner’s will—it is God’s intervening work that rescues us from the just penalty of our sin (Ephesians 2:4-9). In fact, the abuse of Revelation 3:20 often goes hand-in-hand with talk of “asking Jesus into your heart” and other man-centered versions of the gospel message. One way to protect yourself and your evangelism from such skewed perspectives is to closely adhere to biblical language when you’re explaining the gospel. And you were dead in your trespasses and sins, in which you formerly walked according to the course of this world, according to the prince of the power of the air, of the spirit that is now working in the sons of disobedience. Among them we too all formerly lived in the lusts of our flesh, indulging the desires of the flesh and of the mind, and were by nature children of wrath, even as the rest. But God, being rich in mercy, because of His great love with which He loved us, even when we were dead in our transgressions, made us alive together with Christ (by grace you have been saved), and raised us up with Him, and seated us with Him in the heavenly places in Christ Jesus, so that in the ages to come He might show the surpassing riches of His grace in kindness toward us in Christ Jesus. For by grace you have been saved through faith; and that not of yourselves, it is the gift of God; not as a result of works, so that no one may boast. (Ephesians 2:1-9, emphasis added) Train yourself to think about the gospel in those terms, and you’ll insulate yourself from the influence of man-centered theology, and the temptation to reinterpret God’s Word. Whose Door? The door in Revelation 3:20 was not a vague spiritual metaphor—it was a specific door. And while Christ wasn’t physically knocking, His words were directed to a specific group of people, and should not be watered down or applied carelessly to just anyone. The context of Revelation 3:20 is Christ’s letter to the church at Laodicea—also known as the lukewarm church. In Revelation 3:14-22, the Lord condemns them for their spiritual self-deception and apathy. Christ says, “I know your deeds, that you are neither cold nor hot; I wish that you were cold or hot” (v. 15). They did not openly reject Christ, but neither did they exhibit any spiritual zeal or authentic love for God or His Word. They professed to know Christ, but He had no place in their assembly. And lost in their self-deception, they risked being spat out of God’s mouth altogether (v. 16). Their only hope was to truly repent (v. 19). In the context of Revelation 3, then, Christ was standing at the door of the Laodicean church, eager to re-enter the congregation through the genuine repentance and salvation of its members. In his commentary on this passage, John MacArthur explains the imagery of verse 20: Though this verse has been used in countless tracts and evangelistic messages to depict Christ’s knocking on the door of the sinner’s heart, it is broader than that. The door on which Christ is knocking is not the door to a single human heart, but to the Laodicean church. Christ was outside this apostate church and wanted to come in—something that could only happen if the people repented. The invitation is, first of all, a personal one, since salvation is individual. But He is knocking on the door of the church, calling the many to saving faith, so that He may enter the church. If one person (anyone) opened the door by repentance and faith, Christ would enter that church through that individual. The picture of Christ outside the Laodicean church seeking entrance strongly implies that, unlike Sardis, there were no believers there at all. Christ’s offer to dine with the repentant church speaks of fellowship, communion, and intimacy. Sharing a meal in ancient times symbolized the union of people in loving fellowship. Believers will dine with Christ at the marriage supper of the Lamb (Revelation 19:9), and in the millennial kingdom (Luke 22:16, 29-30). Dine is from deipneō, which refers to the evening meal, the last meal of the day. The Lord Jesus Christ urged them to repent and have fellowship with Him before the night of judgment fell and it was too late forever. [1] John MacArthur, The MacArthur New Testament Commentary: Revelation 1-11 (Chicago: Moody Press, 1999) 140. What does repentance look like? Far from merely opening the door of your heart to Christ, true repentance reflects the conviction of your sin and the deep desire for righteousness. Here’s how D. Martyn Lloyd-Jones defined this important doctrine: Repentance means that you realize that you are a guilty, vile sinner in the presence of God, that you deserve the wrath and punishment of God, that you are hell-bound. It means that you begin to realize that this thing called sin is in you, that you long to get rid of it, and that you turn your back on it in every shape and form. You renounce the world whatever the cost, the world in its mind and outlook as well as its practice, and you deny yourself, and take up the cross and go after Christ. [2] D. Martyn Lloyd-Jones, Studies in the Sermon on the Mount (Grand Rapids: Eerdmans, 1974) 2:248. The Urgent Call of the Gospel When it comes to applying and interpreting Scripture, the details matter; good intentions are not enough. We bring the authority of Scripture to bear in sinners’ lives only inasmuch as we handle it accurately. We have a responsibility to the Lord, to each other, and to the unsaved world to proclaim the excellence, inerrancy, and sufficiency of the Bible. And we can’t fulfill that responsibility if we’re assigning our own meaning to God’s immutable truth. With that in mind, you may still want to inject some urgency into the call to repent the next time you share the gospel with friends or family. Rather than falling back on a misappropriation of Christ’s words in Revelation, why not make a biblically sound argument? Here are a couple passages that convey the sinner’s urgent spiritual needs. Isaiah preached to the apostate nation of Israel pleading with them to return to the Lord: Seek the Lord while He may be found; call upon Him while He is near. Let the wicked forsake his way and the unrighteous man his thoughts; and let him return to the Lord, and He will have compassion on him, and to our God, for He will abundantly pardon. (Isaiah 55:6-7) And in Acts 17 Paul ended his gospel appeal to a crowd of philosophers with these words: Therefore having overlooked the times of ignorance, God is now declaring to men that all people everywhere should repent, because He has fixed a day in which He will judge the world in righteousness through a Man whom He has appointed, having furnished proof to all men by raising Him from the dead. (Acts 17:30-31) These and other passages (cf. Acts 2:37-40; Hebrews 4:6-7) can be rightly used to urge unbelievers or those lost in self-deception to respond to the gospel by repenting and turning to Christ. What good is our evangelistic zeal if we aren’t biblically sound? Full Article
whos Florian Schneider: the enigma whose codes broke open pop music By www.theguardian.com Published On :: 2020-05-06T17:47:22Z The Kraftwerk co-founder remained a mystery even after death, but there is no doubting the impact he made with his group’s sublime, visionary musicNews: Florian Schneider, Kraftwerk co-founder, dies aged 73Florian Schneider’s death came shrouded in a degree of secrecy. Gossip among fans about his health was first provoked at the end of April, when his fellow former Kraftwerk member Wolfgang Flür posted a sweet photo on social media of him and Schneider together in a bar, without explanation.It had apparently been taken in 2016 – a decade and a half after Schneider and fellow founder member Ralf Hütter had served Flür with a lawsuit provoked by his autobiography I Was a Robot – and was subsequently deleted from Flür’s Facebook page. Then, a week later, another electronic musician based in Germany, the Manchester-born Mark Reeder, posted a brief eulogy; one commenter claimed that Schneider had died “several days ago”. Continue reading... Full Article Kraftwerk Music Electronic music Pop and rock Culture
whos Zero-waste warriors: meet the people whose household rubbish fits in a jam jar By www.theguardian.com Published On :: 2020-05-06T05:00:03Z From making their own toothpaste to foraging locally for edible plants, more and more people are learning to cut the amount of rubbish they throw out. Here’s how they do itThrough my work, I have seen the huge amount of waste and recycling that we produce. Watching an incinerator for half an hour shocked me and made me want to take action. I was standing on a balcony wearing a full body suit and goggles watching gigantic grabbers emptying waste from trucks. The scale is so shocking and you realise how tiny we are compared to the amount of waste we create. I don’t want to contribute to that wastefulness and it has made me want to take action. Continue reading... Full Article Waste Environment Environmental activism Life and style
whos Welcome to Penguin, whose streets once echoed with the sound of race cars By www.abc.net.au Published On :: Tue, 07 Apr 2020 11:48:39 +1000 Stephen Mott, the author of a new book about a tiny north-west Tasmanian town, is hoping to capture "the atmosphere of 50s motor racing". Full Article Books (Literature) Automobile Enthusiasm Motor Sports Sport
whos Michael McClure, the poet whose roar helped launch the '60s, dies at 87 By www.latimes.com Published On :: Thu, 7 May 2020 10:30:22 -0400 The countercultural poet, actor and musician was present, Zelig-like, at key moments in San Francisco's Beat heyday and beyond. Full Article
whos Federal Court Enjoins Las Vegas Man Whose Tax-fraud Scheme Is Estimated to Have Cost Treasury $31 Million By www.justice.gov Published On :: Wed, 24 Jun 2009 15:33:53 EDT A federal court has permanently enjoined Reinhold Sommerstedt, a Las Vegas-based promoter of a sham trust tax scam. Full Article OPA Press Releases
whos U.S. Seeks to Shut Down Texas Tax Preparer Whose Customers Work Overseas for Defense Contractors By www.justice.gov Published On :: Wed, 19 Jun 2013 10:24:35 EDT The United States sued a Southlake, Texas woman last night, seeking to bar her from preparing federal tax returns for others Full Article OPA Press Releases
whos End of life planning: An idea whose time has come? By webfeeds.brookings.edu Published On :: Tue, 15 Mar 2016 16:52:00 -0400 Far too many people reach their advanced years without planning for how they want their lives to end. The result too often is needless suffering, reduced dignity and autonomy, and agonizing decisions for family members. Addressing these end-of-life issues is difficult. Most of us don’t want to confront them for ourselves or our family members. And until recently, many people resisted the idea of reimbursing doctors for end-of-life counselling sessions. In 2009, Sarah Palin labelled such sessions as the first step in establishing “death panels.” Although no such thing was contemplated when Representative Earl Blumenauer (D- Oregon) proposed such reimbursement, the majority of the public believed that death panels and euthanasia were just around the corner. Even the Obama Administration subsequently backed away from efforts to allow such reimbursement. Fortunately, this is now history. In the past year or two the tenor of the debate has shifted toward greater acceptance of the need to deal openly with these issues. At least three developments illustrate the shift. First, talk of “death panels” has receded, and new regulations, approved in late 2015 to take effect in January of this year, now allow Medicare reimbursement for end of life counselling. The comment period leading up to this decision was, according to most accounts, relatively free of the divisive rhetoric characterizing earlier debates. Both the American Medical Association and the American Hospital Association have signaled their support. Second, physicians are increasingly recognizing that the objective of extending life must be balanced against the expressed priorities of their patients which often include the quality and not just the length of remaining life. Atal Gwande’s best-selling book, Being Mortal, beautifully illustrates the challenges for both doctors and patients. With well-grounded and persuasive logic, Gwande speaks of the need to de-medicalize death and dying. The third development is perhaps the most surprising. It is a bold proposal advanced by Governor Jeb Bush before he bowed out of the Presidential race, suggesting that eligibility for Medicare be conditioned on having an advanced directive. His interest in these issues goes back to the time when as governor of Florida he became embroiled in a dispute about the removal of a feeding tube from a comatose Terry Schiavo. Ms. Schiavo’s husband and parents were at odds about what to do, her husband favoring removal and her parents wishing to sustain life. In the end, although the Governor sided with the parents, the courts decided in favor of the husband and allowed her to die. If an advanced directive had existed, the family disagreement along with a long and contentious court battle could have been avoided. The point of such directives is not to pressure people into choosing one option over another but simply to insure that they consider their own preferences while they are still able. Making this a requirement for receipt of Medicare would almost surely encourage more people to think seriously about the type of care they would like toward the end of life and to talk with both their doctors and their family about these views. However, for many others, it would be a step too far and might reverse the new openness to advanced planning. A softer version nudging Medicare applicants to address these issues might be more acceptable. They would be asked to review several advance directive protocols, to choose one (or substitute their own). If they felt strongly that such planning was inappropriate, they could opt out of the process entirely and still receive their benefits. Advanced care planning should not be linked only to Medicare. We should encourage people to make these decisions earlier in their lives and provide opportunities for them to revisit their initial decisions. This could be accomplished by implementing a similar nudge-like process for Medicaid recipients and those covered by private insurance. Right now too few people are well informed about their end-of-life options, have talked to their doctors or their family members, or have created the necessary documents. Only about half of all of those who have reached the age of 60 have an advanced directive such as a living will or a power of attorney specifying their wishes. Individual preferences will naturally vary. Some will want every possible treatment to forestall death even if it comes with some suffering and only a small hope of recovery; others will want to avoid this by being allowed to die sooner or in greater comfort. Research suggests that when given a choice, most people will choose comfort care over extended life. In the absence of advance planning, the choice of how one dies is often left to doctors, hospitals, and relatives whose wishes may or may not represent the preferences of the individual in their care. For example, most people would prefer to die at home but the majority do not. Physicians are committed to saving lives and relatives often feel guilty about letting a loved one “go.” The costs of prolonging life when there is little point in doing so can be high. The average Medicare patient in their last year of life costs the government $33,000 with spending in that final year accounting for 25 percent of all Medicare spending. Granted no one knows in advance which year is “their last” so these data exaggerate the savings that better advance planning might yield, but even if it is 10% that represents over $50 billion a year. Dr. Ezekiel Emanuel, an expert in this area, notes that hospice care can reduce costs by 10 to 20 percent for cancer patients but warns that little or no savings have accompanied palliative care for heart failure or emphysema patients, for example. This could reflect the late use of palliative care in such cases or the fact that palliative care is more expensive than assumed. In the end, Dr. Emanuel concludes, and I heartily agree, that a call for better advance planning should not be based primarily on its potential cost savings but rather on the respect it affords the individual to die in dignity and in accordance with their own preferences. Editor's note: This piece originally appeared in Inside Sources. Authors Isabel V. Sawhill Publication: Inside Sources Full Article
whos Anti-Littering Campaigns: An Idea Whose Time Has (More Than) Come in Turkey and Iran By www.treehugger.com Published On :: Sun, 22 Aug 2010 10:30:00 -0400 In the northeastern reaches of Turkey, outside the city of Kars, I came across one of the most bucolic scenes I'd ever laid eyes on in the Full Article Business
whos 'Like a kid whose parents are withholding critical information': How workers feel about virtual layoffs By www.cnbc.com Published On :: Fri, 08 May 2020 18:58:35 GMT Companies large and small are handling layoffs over minutes-long, scripted video calls, but workers say there's a better way to handle them. Full Article
whos now whos healthy By www.toothpastefordinner.com Published On :: Sun, 27 Sep 2015 04:00:00 EDT Today on Toothpaste For Dinner: now whos healthyThe Worst Things For Sale is Drew's blog. It updates every day. Subscribe to the Worst Things For Sale RSS! Full Article comic
whos whos that hypeman By www.toothpastefordinner.com Published On :: Fri, 16 Dec 2016 04:00:00 EST Today on Toothpaste For Dinner: whos that hypemanThe Worst Things For Sale is Drew's blog. It updates every day. Subscribe to the Worst Things For Sale RSS! Full Article comic