Ep. 371 Complicated Decisions in the ICU with Travis Rieder

Learn how a bioethicist found himself in a decision-making dilemma after his own father suffered a healthcare crisis and was on a ventilator in the ICU.

My guest Travis Rieder is a bioethicist and the director of the Master of Bioethics degree program at the Johns Hopkins Berman Institute of Bioethics. He is also an author and TED Talk speaker who recently penned an article titled “A Father’s Wish, A Bioethicist’s Dilemma.” He shares the dilemma he faced as a healthcare proxy for his father during a dire health crisis, which sheds light on the challenges of making the best decisions in the moment when the outcome is uncertain. Learn more about his writing at his website:


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This episode includes:

  • What bioethicists do and how Travis was attracted to this field
  • What is “preventable catastrophe” and how that concept informs his work
  • Bioethical challenges during the pandemic
  • The personal dilemma he faced when his father was in the ICU
  • The importance of clear communication during a health crisis
  • Why knowing your loved one’s wishes may not always lead to easy decision-making
  • How to make the best decisions even when information is limited
  • How this experience changed what Travis teaches his bioethics students

Links mentioned in this episode:

  • Volunteer Hospice of Clallam County Soul Care Speaker Series October 12th at Noon Pacific: Register here
  • DDNBC Workshop with Barbara Karnes and Karen Wyatt October 13th at 6:30 pm Pacific: Register here
  • Travis Rieder’s Article: A Father’s Wish, a Bioethicist’s Dilemma”

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If you enjoy this content please share it with others and consider leaving a review on iTunes. Thanks again to all supporters on my page at Patreon.com/eolu, and to Binta Sumareh for making a donation through Paypal! Your contributions make all the difference.


Ep. 249 Improving Advance Directives by Using Video Technology with Fred Mirarchi MD

Learn how video tech is revolutionizing advance directives and about special training for death doulas to become ACP educators.

My guest Dr. Fred Mirarchi is an emergency medicine physician and the principal investigator of the TRIAD Research Series (The Realistic Interpretation of Advance Directives.) He’ll discuss how his research has confirmed that there is a nationwide patient safety risk due to confusion surrounding living wills, DNR and POLST orders. We will also talk about MIDEO, which is a video advance directive and physician’s medical order that improves both the quality and safety of advance care planning, AND his initiative to provide doulas with training to become ACP educators. Learn more at these websites:



Listen here:

Improving Advance Directives by Using Video Technology

This episode includes:

  • Significant problems with living wills and POLST orders revealed by TRIAD research
    • poorly understood by patients
    • misinterpreted by healthcare workers
    • forms not properly completed
  • Poor communication and lack of education create problems with advance care planning
  • “Effective” living will document differs from “Active” living will, which is triggered by a terminal event
  • Why video is more effective than a paper form for documenting patient wishes
  • How MIDEO works for creating video directives
  • Training physicians, doulas and other healthcare providers to help patients create video directives
  • How COVID-19 is currently affecting advance care planning
  • Moral injury is occurring for healthcare providers making difficult decisions during COVID-19

Links mentioned in this episode:

  • Get the book here: 7 Lessons for Living from the Dying
  • Doula training program on ACP and MIDEO
  • Learn about MIDEO here
  • Join the team at Patreon.com/eolu and get access to the EOLU mug“Mind if we talk about death?” (only Patrons can purchase it). PLUS get our new bonuses: the monthly EOL News Update, movie reviews from 2 Doctors and a Movie, and automatic access to A Year of Reading Dangerously!

If you enjoy this content please share it with others and consider leaving a review on iTunes! Thanks again to all supporters on my page at Patreon.com/eolu, especially my newest Patron: Marnie McCourty. Your contributions make all the difference!

End of Life, EOLPodcast

Ep. 203 Do Not Resuscitate: Changing the Culture Around the DNR Order with Frances Myers

Learn how one woman managed to change resuscitation protocols for emergency responders to decrease the incidence of unwanted CPR.


My guest Fran Myers is a healthcare consultant and the founder of the Center for Advance Care Planning. She will share how she investigated protocols for CPR that guide EMS first responders and discovered that they didn’t align with the statutes of the state of Colorado. Her success in changing the protocols is a story that will hopefully inspire people in other  states to take up the same work to ensure that patients receive the care they want at the end of life. Read more about Fran’s work at her website:



Learn about the Advance Directives Portfolio here.

Listen here.


This interview includes:

  • What the public misperceives about CPR and where that mistaken idea comes from
  • Many people still receive unwanted CPR at the time of death in hospitals and nursing homes
  • Why paperwork is often disregarded by first responders in the field during a medical crisis
  • How EMS protocols foster the provision of CPR as a default treatment regardless of the wishes of patients and family members
  • How Fran went about getting the protocols changed in Colorado to allow first responders to withhold CPR when appropriate
  • Advice for people in other states who want to change the protocols in their area
  • How to access the Advance Directive Portfolio for your state of residence

We never say much as we frantically try to save the life we know we can’t save or perhaps silently hope we don’t save. When it’s finally over and the last heart beat blips across the screen and we survey the clutter of bloody gloves, wrappers, masks and needles that now litter the room, you may catch a glimpse as we bow our heads in shame, fearful perhaps that someday we may have to stand in front of God as he looks down upon us and says, “what in the hell were you thinking?”  – Dr. Louis Profeta – Emergency Room Physician

Links mentioned in this episode:

If you enjoy this content please share it with others and consider leaving a review on iTunes! Thanks again to all supporters on Patreon.com/eolu – your contributions mean everything to me!



End of Life, EOLPodcast

Ep. 103 The Truth About CPR: Exposing the Myths

Learn the myths and facts about Cardiopulmonary Resuscitation.


In this episode I’ll discuss the misunderstandings that exist in our society about CPR, primarily due to the way it is portrayed in movies and on television programs, like House and ER. It’s important to know the truth about CPR in order to make the best decisions for our future healthcare.


An Evening withDr. Ira ByockBe sure to sign up for “An Evening with Ira Byock, MD” on August 21st. Help us celebrate the 20th Anniversary of his book Dying Well. You’ll receive the replay if you can’t attend live.

Click here to register.



You can help support this podcast by making a small donation ($1 or $2 per month) at Patreon.com/eolu. Thank you to my latest contributors Karen Greer and Barbara Richardson. I really appreciate your support and it helps me keep the podcast and the End-of-Life University Interview Series on the air! Check out Patreon.com/eolu.


This is a follow-up to the latest interview on EOL University Interview Series with Dr. Fred Mirarchi, and ER physician who has conducted the TRIAD Studies (The Realistic Interpretation of Advance Directives.) In that presentation Dr. Mirarchi shared how advance directives like Living Wills and POLST forms are often misinterpreted by healthcare providers, resulting in patients receiving less or more intervention than they specified in their paperwork. You can listen to Dr. Mirarchi’s talk here.

I discuss:

  • three myths about CPR that are commonly believed
  • the true statistics about the outcome of CPR
  • the difference between CPR and the use of AED’s (automated external defibrillator)
  • when CPR might be called for and when it is likely to cause more harm than good
  • issues to consider when completing your CPR or DNR directive

You can download the handout “Facts About CPR” from the Colorado Advance Directives Consortium by clicking below:

Download the Handout

Remember there will be a new episode every Monday! Until next week …

Face Your Fears.                       BE Ready.                       Love Your Life.