Minnesota Court Strikes Assisted Suicide Statute as Unconstitutional

Today, the Minnesota Court of Appeals published its opinion in State v. Final Exit Network.  The appeals of FEN and several individual defendants concern the constitutionality of Minn. Stat. § 609.215, which criminalizes speech that “advises” and “encourages” another in taking the other’s life.  The district court had determined that criminalizing speech that “advises” suicide violates the First Amendment.  The Court of Appeals...

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20th Anniversary of Landmark Informed Consent Case, Arato v. Avedon

Twenty years ago today, on September 30, 1993, the California Supreme Court issued its opinion in Arato v. Avedon.Arato had been diagnosed with pancreatic cancer.  The oncologists recommended a course of chemotherapy medication and radiation treatment.  But Arato and his wife were never told the statistical probability of his survival (which was quite low). About eight months after his surgery, Arato’s cancer returned and quickly spread. He died shortly thereafter. In the subsequent lawsuit, Arato’s wife alleged that the oncologists...

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U.S. Clinicians Fail to Follow Advance Directives

Today's Sarasota Herald Tribune reports that a recent lawsuit for failure to follow an advance directive is not unique.  Over the past three years, regulators have cited 15 Florida nursing homes for failure to honor advance directives.  But both the frequency and severity of regulatory enforcement is insufficient to motivate better policies and procedures.  Earlier this year, I outlined a broader range of legal sanctions that should...

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Critical Care Consensus Conference on Criteria for Futility?

Over at the Hastings Center's Over 65 blog, Muriel Gillick argues that it "may be time for critical care specialists to convene a consensus conference to see if they can agree on the criteria for futility."   Gillick continues:  "If a majority of the nation’s critical care experts came up with criteria for futility, whether the same ones used in this study or some modification, then Medicare would be in a good position to decide to...

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10th International Conference for Clinical Ethics Consultation

The 10th International Conference for Clinical Ethics Consultation will meet in Paris from April 24-26, 2014.  The theme is "The Patient's Voice."  A preliminary program is available here.The deadline for proposals has been extended to October 10. &nb...

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UK Coroners Court Hears Yet Another Unilateral DNAR Case

I have blogged over a dozen British inquiries into unilateral DNAR orders over the past year.  Yesterday, a coroners court heard yet another.Lawyers for Audrey Hannah Peace questioned Dr. Anthony Macklon, a consultant physician at the University Hospital of North Durham over his failure to tell Mrs. Peace's family that doctors had decided not to resuscitate her if her heart stopped beating.  Dr. Macklon said that Mrs. Peace had stopped...

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Health Law Chair Position at Loyola University Chicago

Loyola University Chicago School of Law is seeking to fill the recently created Bernard J. Beazley Chair in Health Law and Policy.  Inquiries should be directed to Prof. Spencer Weber Waller, the chair of the search committee. Interested candidates should submit an application here.Bernard J. Beazley Chair in Health Law and PolicyLoyola University Chicago School of Law, a well established urban Jesuit law school, is currently seeking candidates...

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New Guidebook - I’ve Got Nothing to Lose by Trying It

The UK charity Sense About Science, has published a new guide, I’ve Got Nothing to Lose by Trying It.  Patients with chronic conditions such as cancer, multiple sclerosis, and motor neurone disease are often desperate for a cure and are particularly vulnerable to being sold false hopes through the internet, the media, and advertising.  The guide is aimed at helping help patients make informed decisions when confronted with the plethora...

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Beth Israel Deaconess Urges Wiser End-of-Life Spending

This week, the Greater Boston Interfaith Organization (GBIO) met with area hospital and insurance leaders to ask what they are doing to make sure health care costs don’t rise any faster than inflation.Beth Israel Deaconess Medical Center CEO Kevin Tabb talked about better coordination of care and attention to quality will reduce spending.  But he also issued a specific challenge to the audience:  help friends and family members curb the...

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Legal Briefing: Home Birth and Midwifery

My latest legal briefing column, "Home Birth and Midwifery," (with Deborah Fisch) has just been published.  Journal of Clinical Ethics 24(3) (Fall 2013): 293-308.This Article covers recent legal developments involving home birth and midwifery in the United States. Specifically, we focus on new legislative, regulatory, and judicial acts that impact women’s access to direct entry (non-nurse) midwives. We categorize these legal developments...

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Hamline University Health Law Institute - 2013 Highlights

The Hamline University Health Law Institute has published its 2013 Highlights, a 24-page booklet summarizing the program and accomplishments from the 2012-2013 academic ye...

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Patient Dies Before Court Rules on Continued Life Support

Just a few days ago, an Akron, Ohio court ordered Summa Hospital to continue life support for William Basheotis.  As is usually the case, this was just a temporary restraining order aimed at preserving the status quo until the parties could muster and present the relevant evidence and legal argument.  But as is very often the case, the court never reached the underlying merits of the lawsuit.  The patient died before the scheduled hearing. &nb...

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Limits of Critical Care Prognostication - 30 Second Video

When Dr. Yankovic first enters the ICU, this looks like a clear case of medical futility.  But Dr. Yankovic persists and is successful in resuscitating the patie...

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Medical Futility Blog - Over 1000 Visits a Day

Medical Futility Blog has been receiving an average of 700 page views per day.  The same content is republished on several other sites (like Westlaw and the AJOB blog) and hits there exceed 300 per day.  So, if my math is right, this blog is getting over 1000 hits per day. &nb...

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Medical Futility is Featured Blog by American Bar Association

Medical Futility is currently the featured blog by American Bar Associati...

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STOP THERAPEUTIC OBSTINACY: PENALTIES FOR ADMINISTERING FUTILE ICU INTERVENTIONS

My latest post over at the AJOB blog:  STOP THERAPEUTIC OBSTINACY: PENALTIES FOR ADMINISTERING FUTILE ICU INTERVENTIO...

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Court Orders Summa Akron City Hospital to Keep Basheotis on Life Support

William Basheotis (78) does not having a living will and his sister, Eugenia (80), is his sole next of kin. Clinicians at Summa Akron City Hospital told Eugenia that her brother was terminally ill and that his life support would cease at 5:00 p.m. on Sept. 13 unless she won a court order or put her brother in another medical facility.On Friday afternoon, just hours before the deadline, Eugenia obtained that court order, keeping her brother...

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Medical Futility Disputes Rarely Belong in Court

I was pleased to see Wesley Smith agree with so much of what leading critical care ethicists Bob Truog and Doug White wrote about the resolution of futility disputes in a recent JAMA Internal Medicine editorial.  But near the end of his column, Smith decidedly departs from Truog and White.  Smith writes: " intractable disputes belong in open court, with a right to discovery, deposition, cross examination, appeal–and press coverage."  In...

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World's Oldest Man Dies at 112

Salustiano Sanchez-Blazquez, the world's oldest man, died on Friday near Niagara Falls, New York. He was 112.  Sanchez-Blazquez is exceptional, since over 90 percent of all super-centenarians are female.  Arturo Licata, 111, of Italy, is now the leading candidate to be officially recognized by the Guinness Book of World Records as the current world's oldest m...

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Growing Legal & Ethical Clarity on Legitimacy of Hastening Death by VSED

In 2011, I argued that voluntarily stopping eating and drinking is a legal option to hasten death.  Specifically, I established thatboth contemporaneous and (most) non-contemporaneous decisions for VSED are legally permissible. Individuals may refuse nutrition and hydration just as they may refuse other intrusions on their personal autonomy. This right is grounded in the common law of battery, statutes, state constitutions, and even the...

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Minnesota Supreme Court Upholds Lost Chance Causation - Again

In May 2013, the Minnesota Supreme Court recognized “loss of chance” as a cause of action for medical malpractice.  No longer must plaintiffs establish "but for" causation.  No longer must plaintiffs establish that without the defendant's negligence it is "more likely than not" there would have been no injury.But by June, the defendants and some professional medical associations petitioned the Supreme Court to rehear the case.  Petitions...

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Futile Interventions Question Medical System's Focus

This well-done 7-minute news report from ABC News Australia is worth another view in light of the widely-reported new JAMA Internal Medicine report measuring the amount of non-beneficial treatment provided in the United Stat...

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Frequency & Cost of Treatment Perceived to be Futile in Critical Care

A UCLA/RAND research team led by Thanh Huynh wanted to better quantify the prevalence and cost of physician-perceived futile treatment in adult critical care.  In an article published (and available for free) online today in JAMA Internal Medicine, the authors write that intensivists report the care they were delivering was futile 11% of the time and probably futile in another 8.6% of the time.  The most common reason why...

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EOL Suicide on Coronation Street

Coronation Street is the longest running soap opera in the world, airing since 1960.  BBC News has announced that the show will explore the issue of the 'right to die' when one of the most popular characters, terminally ill Hayley Cropper, decides that she wants to take control of her death.Hayley has been diagnosed with inoperable pancreatic cancer.  As her health deteriorates she will decide she wants to take her own life.  Hayley becomes very concerned about losing control as the disease progresses.  The palliative care...

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Health Law at APHA Annual Meeting

Last month, I identified four "must go" health law conferences.  This morning, I reviewed the significant number of law-related sessions at November's American Public Health Law Association meeting.  I really must add APHA to my list (now 5 long) of "must go" health law conferences. &nb...

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California Employers Cannot Prohibit Employees from Administering CPR

California Assembly Bill 633 provides:  "An employer shall not adopt or enforce a policy prohibiting an employee from voluntarily providing emergency medical services, including, but not limited to, cardiopulmonary resuscitation, in response to a medical emergency . . . ."   The bill passed out of the Assembly and is being considered by the Senate. A.B. 633 seeks to respond to an incident in Bakersfield earlier this year, in which an 87-year-old woman died following cardiac arrest.  A seven-minute 911 call revealed that...

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Limitations of Big, Fat Ethics Books

I love this scene from the movie adaptation of John Grisham's The Rainmaker.  The scene includes two lawyers played by Danny DeVito and Matt Damon.  The more experienced lawyer, DeVito, is giving some advice to the newly licensed Damon:  "In law school, they don't teach you what you need to know.  It's all theories and lofty notions, and big, fat ethics books."I was reminded of this scene as I prepare to cover informed consent in my Healthcare Quality & Liability class.  I suspect that I would feel much the...

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Doctors Cruelly & Needlessly Prolong Lives of the Dying

While now 20 years old, this quote by Harvard geriatrician Muriel Gillick still has too much truth.Doctors cruelly and needlessly prolong the lives of the dying (for reasons of) avarice and passion for technolo...

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