How the Internet Can Benefit Older Americans

On April 24, 2013, the FCC will host a free Senior Digital Literacy Day seminar, "How the Internet Can Benefit Older Americans."Seniors, and those who work with and/or care for seniors, are invited to attend and learn about how Broadband (high speed Internet services) can benefit older Americans. Panelists, including representatives from the FCC, communications companies and non-profit organizations will focus on the many ways the Internet can...

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Scripps Mercy Changes Course and Agrees to Continue Treatment for Kesell Macias

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Challenges of Surrogate Decision Making

I am excited to be a part of an upcoming Geisinger Health System Conference, "On Another's Behalf: The Law, Ethics, and Challenges of Surrogate Decision Making" on April 10.While not the focus of this conference, Geisinger is well-known for its ProvenCare program.  This program features three key elements: (1) a strict reliance on evidence-based standards in medicine, (2) a fixed-price financial mechanism to pay for certain procedures, and (3)...

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New Case - Kesell Macias v. Scripps Mercy Chula Vista

On Wednesday, Scripps Mercy Chula Vista Hospital informed thefamily of Kesell Macias that they will remove him from life supportagainst their wishes.  The hospital released this statement: When we have a critically ill patient, we provide all the care andservices that are appropriate as ordered by the patient’s physicians. The bestinterests of the patient guide our physicians and caregivers in thesecircumstances. We recognize that these situations are always extremelydifficult and sad for the families involved.When the patient’s...

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The Most Important Conversation: Tools and Techniques for Advance Health Care Planning

On Thursday, April 11, 2013 2:00 PM - 3:30 PM EDT, the ABA and the National Consumer Law Center are hosting a free online webinar:  "The Most Important Conversation: Tools and Techniques for Advance Health Care Planning."A shift in focus has taken place in advance health care planning from a focus on forms and paperwork, to a focus on meaningful conversations about wishes, beliefs and values.  This webinar will discuss the focus on the care planning conversation and how to document the wishes using tools such as living wills, do not resuscitate...

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Pot or Not? Minnesota and the Legalization of Medical Marijuana

On Wednesday, April 10, 2013, from 5:30 p.m. to 7:30 p.m., the Minnesota State Bar Association's Food & Drug Law Section will be hosting a free CLE:  "Pot or Not? Minnesota and the Legalization of Medical Marijuana."Medical marijuana, a controlled substance, is illegal under federal law in the United States.  Possession and distribution is illegal.  Medical marijuana is not approved by the FDA.  Yet, states like California started governing its use as far back as 1996.  Currently, eighteen states approve or...

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S.B. 675 Probably Not Bad for Texas

I did not expect myself to write indefense of Texas Senate Bill 675.  But Iwant to help provide some clarity in the renewed debate over amending the Texas Advance Directives Act.Last week, on behalf of the TexasMedical Association, Dr. Arlo Weltge testified before the Texas Senate Healthand Human Services Committee, against S.B. 675. One line in his written testimony caught my eye:  “As always, physicians remain liable for thedecisions they make that are outside of the standard of care. However, S.B. 675would establish a new standard...

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Get $5000 for a Better Advance Care Planning Tool

Help develop new approaches to catalyze people toward making their wishes known.  The California Healthcare Foundation is sponsoring a contest to develop solutions that will promote awareness and create a compelling experience that leads to more people communicating their preferences by having a conversation, and completing an advance directive or POLST form.Submissions should target non-activated people, and help take a person from pre-contemplation...

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Facebook Can Help You Die - Better

I will be giving two talks on Thursday in Amarillo, Texas, as part of the 2013 Creative Mind Lecture Series: Facebook Can Help You Die - BetterAverting Today’s Biggest Public Health Epidemics with Social MediaI developed these presentations from my late 2012 contribution to an American Journal of Bioethics symposium on surrogate decision making in the internet age. &nb...

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Comparing British and American Approaches to Medical Futility

Elizabeth Dzeng has a nice article in today's Independent comparing British and American approaches to medical futility.  Here are two brief excerpts:"Unlike the US, here in the UK the ultimate decision regarding resuscitation lies with the doctor. The UK General Medical Council stipulates that doctors are not obligated to provide treatments at the end of life, including resuscitation, that would not be clinically appropriate or of overall benefit....

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Awareness in the Vegetative State - 3 Presentations at University of Minnesota

On April 4 and 5, Adrian Owen from the Brain and Mind Institute at the University of Western Ontario will be making three presentations (also here) at the University of Minnesota.  The Search For Consciousness: Detecting Awareness in the Vegetative StateDetecting Awareness in the Vegetative State: Ethical Challenges and Scientific SolutionsWhen Thoughts Become Actions: Functional Neuroimaging in Disorders of Consciousn...

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Shared Decision Making and Patient Decision Aids

My latest legal briefing for the The Journal of Clinical Ethics is out:  “Legal Briefing: Shared Decision Making and Patient Decision Aids."  It was a pleasure to write this with Melinda Hexum with whom I prepared the last legal briefing on POLST.  This is one of the most exciting, and soon-to-be revolutionary, developments in health law and bioethics.  The citation is 24(1) J. Clinical Ethics 2013; 24(1): 70-80.  Here is the abstract:This “Legal Briefing” column covers recent legal developments involving patient decision...

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Senate Hearing on Bill to Improve Texas Advance Directives Act

The Texas Senate Committee on Health and Human Services held hearings today on S.B. 303, which would improve the "futility" provisions in the Texas Advance Directives Act.  The video is available he...

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Appellate Argument in Carter v. Canada

Today and yesterday, the British Columbia Court of Appeals heard oral argument in Carter v. Canada.  (Vancouver Sun')  Last summer, the B.C. Supreme Court held the criminal prohibition of aid-in-dying to be unconstitutional.  Here is a telling quote from Chief Justice Lance Finch:  "Life is more than a pulse or a heartbeat or some little electric activity up here [pointing to his grizzled, grey head]. . . . It’s surely...

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H.R. 1173 - Medicare Coverage for Advance Care Planning

Representative Blumenauer has just introduced H.R. 1173, to amend the Social Security Act to provide for coverage of voluntary advance care planning consultation under Medicare and Medicaid.  Hopefully, his bill will move forward this time. &nb...

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Medical Futility at the American Academy of Neurology Conference

Today is the start of the 2013 Annual Meeting of the American Academy of Neurology.  While there are, of course, ethics sessions on topics such a determination of brain death, there are two that specifically cover medical futility.Ethical Dilemmas in the ICUProgram Description:  Neurologists frequently encounter ethical dilemmas when caring for patients with critical brain damage. These clinical problems have also acquired enormous public exposure through the media. In this program, faculty will discuss crucial topics, such as withdrawal...

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Free Webinar - Exploring the Nature and Meaning of Medical Futility – A Case Involving a Neurologically Devastated 2 Year Old

The Arizona Bioethics Network continues its webinarseries on March 28 with"Exploring the Nature and Meaning of Medical Futility – A Case Involving aNeurologically Devastated 2 Year Old" by Rebecca Volpe, Director of the Clinical Ethics Consultation Service at Penn State College of Medicine.Here is the program description:  "This presentation will explore the nature and meaning offutility.  We will address questions such as What is the relationship betweenfutility and worth? and Are healthcare providers obliged...

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Medical Futility Remains Leading Case of Moral Distress among Nurses

Aggressive medical treatment at the end of life is already well documented as a major cause of moral distress among critical care nurses.  Bolstering this research, Annette Browning just published the results of a new survey in the March 2013 issue of the American Journal of Critical Care.    On a 7-point Likert scale, the following all had intensity scores between 5 and 6:Follow family’s wishes to continue life support when not in patient’s best interestFollow physician’s orders for unnecessary testsInitiate life-saving actions...

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VSED - Call for More Understanding and Discussion

JimDeMaine has a newpost on VSED at super blogKevinMD.  DeMaine regularly blogs at Endof Life - thoughts from an MD.DeMaine writes that "dying by VSED deserves more understanding anddiscussion. . . .  VSED need not be the slippery slope toward euthanasia some mightthink, but with the care outlined by ethicists and palliative careexperts like Quill and Byock, there is hope that many options willbe available to us at the end.  After all, it is our life, our body, andwe all have a time to die."I completely agree, an have...

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National Healthcare Decisions Day in Minnesota

National Healthcare Decisions Day is about one month away, on April 16, 2013.  Here in Minnesota, two NHDD events are co-sponsored by the William Mitchell College of Law and the Hamline University Health Law Institute.  There will be two separate free ACP clinics:  (1) one at William Mitchell from 9 am to 7 pm, and (2) one at the MS Society from 1:30 to 7:00 pm.&nb...

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Aintree Hosp. v. James - Appellate Court Permits Clinicians to Stop "Futile" Treatment

A British appellate court has ruled that doctors should be allowed to withhold life-sustaining treatment where it would be “futile” to continue it.  Aintree University Hospital NHS Foundation Trust v David James and Ors [2013] EWCA Civ 65.  I have posted a copy of the Opinion here.BACKGROUNDAs I wrote in December, musician David James suffered complications from cancer.  He was given six minutes of cardiopulmonary resuscitation (CPR) in August 2012 after a heart attack and ended up in a minimally conscious state, although...

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Healthcare Consent Quality Collaborative

I have not yet had a chance to review all the content, but I wanted to let you know about a valuable new website by the Healthcare Consent Quality Collaborative.  It is collects and organizes Canadian legal and other authority on consent, especially as it pertains to end-of-life decisio...

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National Aging and Law Conference - Call for Proposals

The National Academy of Elder Law Attorneys and co-sponsors of the National Aging and Law Conference invite you to submit proposal(s) to share your knowledge, expertise, and experience at the 2013 National Aging and Law Institute, in Washington, DC from November 7-9, 2013. The theme, this year, is Client Advocacy in Caring Communities.Do the elder law and aging rights communities have the advocacy skills to ensure our clients will age in a caring community? Making a caring community a reality for our clients is a formidable task at a time when...

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Tyler v. Genesis - Family Sues Maryland Facility for Stopping Life Support without Consent

The family of longtime Baltimore Orioles umpires attendant Ernie Tyler is suing a Baltimore nursing home, claiming that a doctor at the facility cut off life-sustaining care to Tyler without authorization.  (Baltimore Sun)I have posted a copy of the Complaint here.  The lawsuit, filed Tuesday in Baltimore Circuit Court, alleges that a day after Tyler checked into Genesis ElderCare Long Green Center in February 2011, his attending physician,...

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Taiwan Promotes Rejection of Futile Medical Treatment

Yesterday, the Taiwan Alliance for Healthcare Excellence teamed up with 19 health groups nationwide to promote rejection of futile medical treatment for terminally ill patients.  (Taiwan Today)“Patients can only die peacefully when medical teams help family members let go in the face of death, rejecting further pointless treatment,” TAHE President Lien Jui-meng said.  Huang Sheng-jean, superintendent of National Taiwan University Hospital’s Jinshan branch, said futile medical care serves only to protract the process of dying. “It’s unethical...

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Legal Debate Over Doctor-Assisted Suicide

I am delighted to be a guest on the Diane Rehm show tomorrow.  DescriptionMontana’s House of Representatives passed a bill that could imprison doctors for assisting in suicide.  Legislation is pending in other states to make it legal.  A panel joins Diane to discuss the legal and political debate over end-of-life issues.GuestsThaddeus Pope - director of the Health Law Institute and associate law professor at Hamline University School of Law.Dr. Joanne Lynn - geriatrician, hospice physician and director of the Altarum Institute Center...

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Nurse Refuses to Perform CPR on Resident

This assisted living facility apparently has a policy that forbids staff from performing CPR on residents who stop breathing.  This really annoys this 911 dispatch...

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Minnesota, like Michigan, to Require Futility Policy Transparency

Minnesota Senator Nienow has reintroduced a bill from last session that would require hospitals to disclose their medical futility policies when they might be applied to a minor.  Michigan has introduced similar legislation. &nb...

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