Prince Friso - British versus Dutch Law on When It Is Time to Stop Life Support?

Prince Friso (of the Dutch Royal Family) has been in a coma for six months after he was caught in an avalanche while skiing in the Austrian resort of Lech.  The prince had been buried for 25 minutes, followed by a 50-minute CPR to treat his cardiac arrest.  The prince remains at a British hospital.The six month point is key temporal threshold.  A medical ethics specialist at the University of Rotterdam Erasmus Hospital...

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The Silent Majority: Who Speaks at IRB Meetings?

In a new article in IRB Ethics titled "The Silent Majority: Who Speaks at IRB Meetings?" Philip J. Candilis and colleagues observe that "institutional review boards (IRBs) are almost universally considered to be overworked and understaffed. They also require substantial commitments of time and resources from their members. Although some surveys report average IRB memberships of 15 people or more, federal regulations require only five."Candilis and colleagues present data on IRB meetings at eight of the top 25 academic medical centers...

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Coma - New Film Adaptation on A&E

Here is something for your Labor Day weekend.  A&E Network presents "Coma," a modern day retelling of the bestselling novel by Robin Cook.  This is a four-hour epic two-night event from Ridley and Tony Scott featuring a multiple Academy Award and Emmy Award-winning cast with Lauren Ambrose, Steven Pasquale, Geena Davis, James Woods, Ellen Burstyn, and Richard Dreyfuss.At a time when "we are living in an aging society . . . have [medical science and physicians] done [their]job far too well?" Are we living too long, and how much should...

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2012 Publications Collage

Here are covers of some of the articles and book chapters that I published in 20...

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UPDATE: McDaniel v. Cook Children's Medical Center

I blogged a few days ago about the case of Zach McDaniel.  Cook Children’s Medical Center in Fort planned to stop Zach's life-sustaining treatments over his parents' objections.  While Texas law provides a simple (too simple) mechanism for doing this legally, it is unclear that the hospital complied.  So, the hospital planned to start over and go through the proper process.  But before it could so, Zach was transferred...

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New End-of-Life Care E-Learning Session

A new e-learning session focusing on the General MedicalCouncil’s new guidance on treatment and care towards the end of life is nowavailable via e-ELCA, End of Life Care for All. The new e-ELCA session explores the fictional case studies of twopatients with different conditions and allows the users to work through thedecision making process alongside the doctor, the patient and those close tothem.  The case studies cover bothmanaging a patient’s request for treatment and a patient’s advance refusal oftreatment.  It gives doctors...

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Bella Addormentata (Sleeping Beauty) 2012 Film

A new film titled "Sleeping Beauty" is based on the story of Eluana Englaro the Italian young woman in a PVS whose family fought a long legal battle to withdraw her treatment.  The film is now in competition at the Venice Film Festival.  Here is the synopsis:  The film takes place in various parts of Italy over six days, which are Eluana Englaro’s last and whose story remains in the background. The stories of fictional characters from different faiths and ideologies are connected emotively to that case, in an existential reflection...

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Should we ration Medicare services for end-of-life care? (Poll results)

From a poll in the Kalamazoo News:Should we ration Medicare services for end-of-life care?Yes. We have finite resources, and Medicare should have protocols to prevent unnecessarily prolonging the dying process. 32.67%  (49 votes)  No. Medicare should pay for what doctors order and families want. 17.33%  (26 votes)  No rationing, but senior citizens should be encouraged to detail their wishes for end-of-life care. 50%  (75 votes) &nb...

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Mr. L, a British Hassan Rasouli?

A case now pending before the Court of Protection at the High Court in London (Mr. Justice Moylan) has some uncanny parallels to the Hassan Rasouli case pending before the Supreme Court of Canada.55-year-old Mr. L., like 60-year-old Mr. Rasouli is a Muslim who believes that "you prolong life as far as you can and that you actively take every step to do so."  The family wants him kept alive as long as possible so that he can die "a good Muslim death."Mr. L., after a hypoxic bain injury from a severe heart attack five weeks ago, was diagnosed...

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Due Process under the Texas Advance Directives Act

I was re-reading a famous Texas case this week, Burditt v. Dept. of Health & Human Services, 934 F.2d 1362 (5th Cir. 1991).  It provides an interesting contrast to the dispute resolution mechanisms in the Texas Advance Directives Act.The on-call obstetrician at DeTar Hospita in Victoria, Texas refused to treat Rosa Rivera who had arrived in labor and with dangerously high blood pressure.  Dr. Burditt wanted to transfer Rivera to another hospital without first stabilizing her (EMTALA-defined) emergency medical condition.  The...

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McDaniel v. Cook Children's Medical Center

In contrast to 2007 to 2010, the press has not lately beencovering many cases involving Texas hospitals’ unilateral refusal oflife-sustaining treatment.  But there isone new case this month (reported by Spero News).12-year-old boy, Zach McDaniel suffered a gunshot wound tohis head as a bystander during a drug-deal in Abilene, Texas.  Zachunderwent emergency surgery and then was transferred to Cook Children's MedicalCenter in Ft. Worth for advanced treatment.Upon transfer, Zach was admitted to the pediatric intensive careunit. Heavily...

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End-of-Life Documentaries and Films

In February 2012, the NVVE organized a Documentary Film Festival focused on euthanasia and other choices around the self-chosen life. A total of 38 feature films and documentaries were screened during the festival.The NVVE is now supporting a website that gathers foreign feature films, short films and documentaries about all the choices around the self-chosen life.  Many are available to watch online directly from this si...

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New University of Memphis Center for Health Law

The University of Memphis Cecil C. Humphreys School of Law is seekingthe founding Director for its new Center for Health Law.  The position announcement notes:The Director’s responsibilities will include strategic planning,fundraising, curriculum development, maintenance and growth of relationshipswith relevant local, national, and international scholarly and professionalassociations, scholarship production, teaching, and mentoring.The Law School seeks to expand its health-law curriculum and relatedhealth-law opportunities for the purpose...

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Cuthbertson v. Rasouli - New Factums Filed

Over the past few weeks, several interveners in Cuthbertson v. Rasouli have filed factums with the Supreme Court of Canada.  I have posted them here.  I will provide commentary shortly.  Euthanasia Prevention CoalitionCanadian Critical Care SocietyMental Health Legal Committee and HIV & AIDS Legal Clinic OntarioEvangelical Fellowship of CanadaAdvocacy Centre for the Elde...

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Religiously Motivated Parents Demand Aggressive Life-Sustaining Treatment

An article published "Online First" in the Journal of Medical Ethics in March 2012 has just been widely reported around the world -- "Should religious beliefs be allowed to stonewall a secular approach to withdrawing and withholding treatment in children?"The physician authors claim that terminally ill children with no hope of survival are subjected to needless suffering amounting to "torture" by parents who refuse to allow the withdrawal of treatment because of their religious beliefs.  The authors argue that families with...

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Effect of Financial Relationships on the Behaviors of Health Care Professionals: A Review of the Evidence

Law professor Christopher Robertson and twomedical colleagues have a new paper forthcoming in the Journalof Law, Medicine and Ethics, titled "Effect ofFinancial Relationships on the Behaviors of Health Care Professionals: A Reviewof the Evidence."  Here is the abstract:This paper explores the empirical evidenceregarding the impact of financial relationships on the behavior of health care providers, specifically, physicians.  Weidentify and synthesize peer-reviewed data addressing whether financialincentives are...

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British Courts Allow Clinicians to Stop Life Support over Parents' Objections

Just a few days ago, I blogged about the London High Court decision in Baby X, permitting clinicians to remove a baby's life support over the parents' objections.  This morning, the British newspaper (Daily Mail; Telegraph) are reporting another London court decision permitting providers to stop treatment (ECMO) for an eight-year-old boy over his parents' objections.THE COURT DECISIONOn Friday, Mr Justice Ryder (Family Division) said there was...

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Seven Myths about Getting Old

Clinician recommendations to forgo curative treatment and/or life-sustaining treatment are often driven by clinician ageism rather than by the patient's health.  Here is a nice reminder that age only loosely correlates to declining health status and reduced medical possibilities: "Seven Myths of Getting Ol...

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Limits of End-of-Life Prognostication

This month's The Hospitalist includes a basic review of some of the limits to end-of-life prognostication.  Among other things, the article includes a table summarizing several helpful end-of-life prediction tools.  But as critical care medicine superstar Randy Curtis puts it, "Predictions really apply to groups of people, not individuals. . . .  Physicians can't possibly know whether someone will fall into the 95% of patients who die or the 5% of patients who beat the odds." &nb...

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The Shadow 'OF' of Courts and the Shadow 'ON' the Courts in Medical Disputes

In the United States, we often speak of the "shadow of the law" on informal dispute resolution.  In China, it appears that there is an opposite phenomenon: the shadow of informal dispute resolution on the courts.In a new article forthcoming in the Columbia Law Review, Benjamin Liebman discusses "Malpractice Mobs: Medical Dispute Resolution in China."Liebman describes a trend toward resolution of claims through protest and violence.  He...

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Health Law Mediation Training

Mediation Training Offered by the AHLA Alternative Dispute Resolution Service in partnership with the Hamline University School of Law, a leader in dispute resolution and health lawMediation Training: Friday, October 19, 2012 from 8:30 am-5:30 pm (Central); Saturday, October 20, 2012 from 8:30 am-5:30 pm; and Sunday, October 21, 2012 from 8:30 am-12:30 pm.You will acquire the knowledge and skills to mediate a health law dispute effectively and ethically. The training is highly interactive and provides extensive coaching and feedback....

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"Saving Hope" Dramatization of CCB Hearing

In "Heartsick," this week's episode of Saving Hope, Charlie was anincapacitated patient.  Charlie's ex-wife and fiance, Alex and Dawn, disagreed about histreatment plan.  They argued their cases in front of a Consent andCapacity Board panel.Alex and Dawn hadvery different views of what Charlie would want. Dawn believed he'd want to diewith dignity and never want to be in a helpless, vegetative state for the restof his life. Alex was insistent that Charlie was still in there and he wouldwant to try everything possible so he could fight...

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Death Denial - Norman Rockwell

I was intrigued by this painting, " Second Holiday," that I saw yesterday afternoon at the Cummer Museum in Jacksonville, Florida.  Norman Rockwell created this illustration for a short story in American Magazine in 1939. The short story takes place at a clinic in Minnesota, where an elderly couple sits in a waiting room. Avoiding eye contact, the man and woman sit side by side and stare into space as their arms intertwine. The...

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ASBH 2012 Annual Meeting - Brochure

The 2012 Annual Meeting brochure for ASBH is now available he...

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NHS Trust v. Baby X - British Court Orders Baby Removed from Ventilator over Parents' Objections

Mr Justice Hedley at London's High Court hasruled that a brain-damagedbaby should be allowed to die even though his deeply religious parents want himkept alive on a life-support machine.  (The reported case opinion is here.)  The one-year-old had a'catastrophic accident' in May and is in a coma.  But Justice Hedley ruledthat it's in the child's best interests if he is now given palliative care. He said it was...

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In re GS: Ontario CCB Permits Hospital to Stop Heroic Measures

The Ontario Consent andCapacity Board has ruled that an Ottawa hospital can stop"heroic measures" for GS, a 90-year-old car crash victim.  (TheReason for Decision is here.) The patient's daughter and substitute decision maker objected. But the CCB ruled that the daughter was bound by GS's advance directive. The board also deemed the proposed treatment plan to be in GS’s bestinterests. “Nothing in evidence suggested that, in these circumstances, GSwould want to be subject to unnecessary medical interventions …...

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Delaware End-of-Life Coalition

I was pleased to see that the Delaware End-of-Life Coalition, an organization with which I was involved when I worked in Delaware 2007-2011, has launched a fresh, new website. &nb...

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