...
Thứ Sáu, 27 tháng 7, 2012
Hospital Stops Life Support after Nonpayment
Indian newspapers (for example, here and here) are reporting that doctors at a government hospital in Jalandhar allegedly refused to provide life support system to a three-day-old girl — who later died — after her father failed to pay a paltry sum of Rs 200 for treatme...
Thứ Tư, 25 tháng 7, 2012
Outpatient Palliative Care
Here is another great story by Mercury News writer Lisa Krieger. She covers the now well-known benefits of palliative care, the reimbursement incentive obstacles to its much-needed expansion, and a great new "outpatient palliative care" program in the bay area. &nb...
Thứ Ba, 24 tháng 7, 2012
Futility Case at Stollery’s Children’s Hospital in Alberta
A 28-month-old child lies in a hospital on lifesupport, with brain injuries so severe that doctors believe she’ll never recover. Her parents are charged with aggravated assault, criminal negligencecausing bodily harm, and failing to provide the necessities of life. Theyrefuse to discontinue life support for their daughter, citing their religiousbeliefs. The Edmonton Journal describes the dispute as a"jurisdictional mess" — with...
Thứ Hai, 23 tháng 7, 2012
The Death(s) of Usher's Stepson Kile Glover
The confusion between brain death and death is probably not going to dissipate anytime soon. For example, multiple national media are reporting the "passing away" of Usher's 11-year-old stepson Kile Glover "after being taken off life support." But they also note that Kile already "was pronounced dead over a week ago after being involved in a jet-ski accident." Worse, matters seem to have been further confused by neurologist Dr....
Chủ Nhật, 22 tháng 7, 2012
Removing Your Own Ventilator is Not Suicide
The LA Times reports that Palm Springs, CApolice arrested Bill Bentinck earlier this month. He walked into the roomof his terminally ill wife. She had disconnected her oxygen supply. Bentinck ased her if she was sure. She was. He and his wife then held hands and professed their lovefor each other. After a while, she stopped breathing. "It was a verypeaceful death," Bentinck said. "She didn't struggle at all. She justwent to sleep." Bentinck then calledhospice a few hours later. Even though...
Thứ Sáu, 20 tháng 7, 2012
Public Health Perspective on End of Life Care
There is an urgent need for public healthto adopt dying and palliative care as a major public health priority, forinstance in national health strategies, and for palliative care to adopt apublic health perspective to improve circumstances of dying at a populationlevel.Worldwide, more than 50 million people die each yearand it is estimated on the basis of the conditions leading to death that up to60% of them could benefit from some form of palliative...
Bentham and Others with Controversial Wills
Here is an interesting and entertaining summary of some famous people with unusual and interesting wills. &nb...
Thứ Năm, 19 tháng 7, 2012
Expiration Date (Theater Performance)
I am pleased that the Hamline Health Law Institute is sponsoring a performance of "Expiration Date" in conjunction with its November 8-9, 2012 Symposium on Legal, Medical, and Ethical Issues in Minnesota End-of-Life Care. Here is a brief clip: &nb...
Honoring Choices Minnesota - Annual Meeting
Honoring Choices Minnesota is an effort of the Twin Cities Medical Society and its foundation. Today, about 90 professionals leading the effort will gather in Minneapolis for an annual meeting to gauge where they are and what remains to be done. (Star Tribune) Attendees will:Share the progress and findings of local advance care planning programs. Identify best practices for advance care planning through reports from clinics, hospitals, community and other sites. Discover new perspectives from guest speakers,...
Thứ Ba, 17 tháng 7, 2012
Junior Scholars in Bioethics Workshop 2013
The Center for Bioethics, Health and Society at Wake Forest University has announced its second Junior Scholars in Bioethics Workshop from March 21-23, 2013.The Workshop gives junior (untenured) faculty working in bioethics an opportunity to present works-in-progress to scholars in bioethics and related fields. Commentators will provide constructive feedback to presenters with the goal of fostering scholarship in bioethics. Works-in-progress will be read in advance by a group of experienced scholars in...
Chủ Nhật, 15 tháng 7, 2012
Physician's Unilateral Vent Withdrawal Triggers Homicide INvestigation
A physician who was charged with unilaterally withdrawing mechanical ventilator from an elderly patient was largely exonerated by the medical registration board. But now, according to Australia's ABC News, the allegations have been referred to Queensland's Crime and Misconduct Commission (CMC). The CMC has appointed a former Supreme Court judge to examine what it calls a series of allegations and has referred material to the homicide squ...
"Comply with Treatment Plan or Lose Your POA"
This is an interesting take on the Ontario CCB from the family's perspective. Marilyn Nelson's husband, Arthur, had a stroke and was admitted to hospital. Physician to patient's wife: "Comply with the treatment plan or lose your power of attorney. One of us must go, and it's going to be you." &nb...
Thứ Bảy, 14 tháng 7, 2012
'Fix the Debt' Campaign
"Fix the Debt"is a project of the nonpartisan Committeefor a Responsible Federal Budget, focused on tackling the national debtwith a comprehensive plan It is launching next Tuesday, July 17.The Fixthe Debt campaign is bringing together business leaders, political leaders, andAmericans of all kinds to find a bipartisan solution that reverses our descentinto debt and strengthens our economy. The campaign will educate andengage the public to promote an informed discussion and prompt action in thebest interests of the...
Thứ Sáu, 13 tháng 7, 2012
Economics Institute for Law Professors
I am heading off, this weekend, to the 28th Economics Institute for Law Professors. The goal of the Institute is to help participants enhance their understanding of economics and broaden their analytical tools in order to introduce greater economic sophistication and policy relevance to their professional work. Alumni routinely credit the Institute with providing creative insights into research and teaching, and with facilitating...
The Disabled: Coercion to Hasten Death?
For decades, commentators have expressed concern that, where the option is available, the disabled will be coerced to hasten their own deaths. It is one of the key objections to the legalization of physician aid-in-dying. Indeed, the risks of coercion are real. And they exist not only with respect to PAID but also in other contexts, as famously illustrated by the quadriplegic right-to-die cases (Bouvia, McAfee..) of the 1980s. The risks of this coercion are powerfully stated in a new article by William J. Peace in the Hastings...
Western Michigan Medical Humanities Conference
Submissions for Western Michigan's Medical Humanities Conference close over the weekend, if you're interested in submitti...
Thứ Năm, 12 tháng 7, 2012
When May a U.S. Clinician Refuse Non-beneficial Treatment?
In most U.S. jurisdictions the legal right of a clinician to refuse a patient/surrogate request for life-sustaining treatment can be represented by the following categorical syllogism:Major premise: Healthcare providers may (without sanction) unilaterally refuse to initiate or continue requested interventions outside the standard of care.Minor premise: Intervention x is outside the standard of care.Conclusion: Therefore, the provider may withhold or withdraw x, even without patient or surrogate consent.Both the law and the logic...
Proposal to Amend the Patient Self Determination Act
The American Bar Association is meeting in early August. One resolution for the House of Delegates to consider is Resolution 106A.COMMISSION ON LAW AND AGINGSECTION OF FAMILY LAWSENIOR LAWYERS DIVISIONGENERAL PRACTICE, SOLO AND SMALL FIRM DIVISIONREPORT TO THE HOUSE OF DELEGATESRESOLUTIONRESOLVED, That the American Bar Association urges Congress to amend the Patient-Self Determination Act (PSDA) provisions of the Medicare and Medicaid law to require that:1. Every patient or patient’s authorized representative be given an opportunity to discuss...
Thứ Ba, 10 tháng 7, 2012
Factors Important to Patients' Quality of Life at the End of Life
A new study in the Archives of Internal Medicine identifies the "Factors Important to Patients' Quality of Life at the End of Life." Factors tending to negatively affect QOL include:Intensive care unit stay, −5.61 Death in the hospital, −3.03 Worry or anxiousness, −0.39 Chemotherapy during the last week of life, −3.46Feeding tube during the last week of life, −3.54 Factors tending to positively affect QOL include:Pastoral care in the hospital or clinic, 1.60 Therapeutic alliance with physician, 1.45 Religious...
Death Cafe
An Ohio woman is opening the country's first ever Death Cafe, "a safe place for people to meet and talk about their fears, concerns, and opinion...
Thứ Hai, 9 tháng 7, 2012
The Most Expensive Medicare Patient
The Wall Street Journal has a great article on the transplants and the many months of critical care provided to Scott Crawford, the fifth costliest Medicare beneficiary in 2009. His care that year totaled $2.7 million. But even independent of the cost, the case triggered all the usual medical futility issues: nurse moral distress, an ethics consult... For a public story is is unusually richly detail...
Chủ Nhật, 8 tháng 7, 2012
ICCEC Conference: March 2013 in Munich
The 9th International Conference on Clinical Ethics and Consultation (ICCEC) will be from March 14-16, 2013 in Munich, Germany. I enjoyed earlier iterations of this conference in Croatia and Portland. This year's local hosts intend to strengthen the bridge between clinical medicine and ethics by providing a forum for the exchange of experience and discussions between clinicians, ethicists and ethics consultants. In particular, they plan to present “role model consultations” based on real clinical cases from intensive...
Overcoming Death Denial
Last Saturday morning in Chicago, I listened to a compelling presentation by "spiritual activist, teacher, author and ceremonialist" Stephen Jenkinson on "The Skill of Brokenheartedness: Euthanasia, Palliative Care and Power." One point that Jenkinson made is that we are a death denying culture . . . and this will not change. He recognized that might not be a welcome message among hundreds of attendees at a Compassion &...
Thứ Năm, 5 tháng 7, 2012
British End-of-Life Quality Survey
The British Office for National Statistics (ONS) has released the National Bereavement Survey 2011. Among other things, the data show:Only 50 per cent of hospital nurses showed dignity and respect towards patients at the end of their lives, compared to 80 per cent of hospice nurses And just 30 per cent of people who died in hospital were given a choice about where they died, whereas the figure was double that for those in a hosp...
Michigan Peace of Mind Registry
Joanna Lax at Dykema has a greatpost about the new Michigan Peace of Mind Registry. I have excerpted a bit of her excellent postbelow.What is the new database?On June 18, 2012, MichiganGovernor, Rick Snyder, signed legislation establishing the “Peace of MindRegistry”—a cutting-edge, statewide electronic database for storingindividuals’ health care advance directives and organ donation documents.Individuals in Michigan will be among the first in the nation to be ableto electronically upload or send via snail mail, their signed...
Foundational works of scholarship in health law
The American Society of Law, Medicine & Ethics, the AALS Section of Law, Medicine & Health Care, and the American Health Lawyers Association are seeking nominations of foundational works of scholarship in health law, very broadly defined, published in English before December 31, 2010.They intend to publish an edited volume in an academic press. The first round of nominations will close on December 31, 2012. Nominations must be accompanied by a brief description, not to exceed 300 words, of the importance of the scholarly work,...
Thứ Tư, 4 tháng 7, 2012
Cervantes v. Rady Children's Hospital
On Friday, I blogged about the case of Cervantesv. Rady Children's Hospital. Two-year-oldZody Cervantes had meningitis and suffered a seizure in an emergency roomnearly two months ago. He was then transferred to Rady Children’sHospital where he’s being treated for a severe brain injury. Last week,Zody's mom Laura Nieves said doctors visited her twice and told her theyplanned to take the boy off life support. Both times Nieves...
Duluth, MN End-of-Life Talk on July 8
Speaker Janet Conn, President of Compassion and Choices ofMinnesota will speak on the broad picture of public policy, the futuredirection of advocacy and the current public discussion regarding care for theelderly, family decision-making for health care, hospice services and decisionsabout end of life. A question and answer period will follow. AdmissionInformation: FreeTime: July 8th at 2:00 pmLocation:Duluth-Superior Friends Meeting House1802 East First StreetDuluth, MN 55...
Thứ Hai, 2 tháng 7, 2012
Health Law at SEALS
The final agenda for the SEALS conference in Amelia Island, Florida, later this month, is now available here. There are, especially relative to all the other areas of law that could be included, quite a few sessions on health law topics. I look forward to seeing you there. I will be coming to SEALS straight off two weeks in Colorado at the Economics Institute for Law Professo...
Chủ Nhật, 1 tháng 7, 2012
Legality of U.S. Physician Aid-in-Dying
It struckme, yesterday, that much of the legal work of Compassion& Choices is not about changingthe law but more about clarifying thatthe existing law (already) does not prohibit physician aid-in-dying. Hereare four examples:1. In Hawaii and New Mexico, (as earlier in Connecticut) the argumentis basically that any criminal prohibition on "assisted suicide" doesnot extend to a physician's lethal prescription for a competent terminally illpatient. That conduct does not constitute...
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