Adelaide Project to Stop Futile Hospital Treatment

The Southern Adelaide Health Alliance is a strategic partnership between Southern Adelaide Local Health Network, Southern Adelaide-Fleurieu Kangaroo Island, Medicare Local, SA Ambulance Service and Health Consumers Alliance of SA.  Next month, SAHA will trial a program to stop futile hospital treatment of the dying elderly.  The program is designed to help doctors make better-informed decisions about patient care and to improve the final moments of people’s lives.  Dr Chris Moy explained:  “A lot of the people in ICU are put...

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Today in the History of End-of-Life Law

This day in history, March 31:In 1976, the New Jersey Supreme Court ruled that Karen Ann Quinlan, who was in a persistent vegetative state, could be disconnected from her respirator. (Quinlan, who remained unconscious, died in 1985.)In 2005, Terri Schiavo, 41, died at a hospice in Pinellas Park, Fla., 13 days after her feeding tube was removed in a wrenching right-to-die dispu...

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End-of-Life Law, Ethics & Policy - What to Read

When I read articles longer than a short blog post, I read them in hard copy.  I underline.  I circle.  I make margin notes.Here is my 'on-deck' reading relating to medical futility and end-of-life decision maki...

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Medical Futility - 350 Slides in 50 Minutes at Yale

I broke me own record of using 200 slides per hour.  Last night, at the Yale School of Medicine, I used 350 slides in my 50-minute presentation.  The slides are here.  I really like the format for the Biomedical Ethics Program talks.  Instead of leaving just 10-15 minutes of time for interactive discussion with participants (as is often the case for conferences and grand rounds), Yale left 45 minutes.  I hope...

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Disability Rights Protection . . . for the Dead?

The family of Jahi McMath gave an interview to Philadelphia reporters while in town to receive an award at the Terri Schiavo Life & Hope Award Gala.Bobby Schindler observed:Jahi’s family persevered through extreme pressure from doctors, media and public opinion to enable their child a chance to be properly cared for.More and more these medical decisions are being put in the hands of hospitals and physicians rather than the way that it used to be where the family was the one making these types of decisions.Just because ... they can't do...

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End-of-Life Decisions for Extremely Low-Gestational-Age Infants: Why Simple Rules for Complicated Decisions Should Be Avoided

In the February 2014 issue of Seminars in Perinatology Annie Janvier and colleagues in Montreal again eloquently and cogently question the status quo.  So many articles on medical futility do not add much that is new or original.  This article really does.  Here is the abstract for "End-of-Life Decisions for Extremely Low-Gestational-Age Infants: Why Simple Rules for Complicated Decisions Should Be Avoided" Interventions for extremely preterm infants bring up many ethical questions. Guidelines for intervention in the “periviable”...

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The Dead Shall Be Raised

Odd experience.  I come to Yale to speak about medical futility.  Directly across the street from the law school is this cemetery with a sign that says "The dead shall be raised." &nb...

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NIHSeniorHealth Adds End of Life Module

NIHSeniorHealth.gov is a superb website for older adults that makes aging-related health information easily accessible for family members and friends seeking reliable, easy to understand online health information.  The site was developed by the National Institute on Aging (NIA) and the National Library of Medicine (NLM) both part of the National Institutes of Health (NIH).  Not only the content but also the design is guided by a research-based approach.  Changes in memory, text comprehension, information processing speed and vision...

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Priceless: Failure of US Healthcare Spending to Increase Life Expectancy

Here is an infographic that places healthcare and healthcare spending into a broader context:  "Priceless: Failure of US Healthcare Spending to Increase Life Expectancy."Source: BestNursingMasters....

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The Place of Refusal of Food and Hydration in End of Life Decision Making

For far too long, VSED / VRFF has been largely neglected in the bioethics literature and in social discourse.  But, as my recent blog posts illustrate, the tide may be turning.  As yet one more sign of this shift, Oxford University Professor Julian Savulescu will speak about the place of refusal of food and hydration as a legal and ethical form of assisted dying at QUT School of Law's 2014 Health Law Research Centre annual public lecture...

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VSED / VRFF - Example of Dorothy Conlon

Sarasota, Florida's Herald-Tribune newspaper has a fantastic website on the life and death of Dorothy Conlon.  Conlon recently decided to hasten her death by voluntarily stopping eating and drinking (VSED).  I have written about the legality of VSED (aka voluntarily refusing food and fluid VRFF) both here and here.  But the Herald-Tribune website provides a very nice first-person perspective on approaching and going through the...

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CALL FOR PAPERS & PRESENTERS Health Care Reform: Implementation in Minnesota

The Hamline University Health Law Institute and Hamline Law Review, with the major support of Medica Health Plans, are working together to produce a day-long CLE/CEU Symposium on Friday, October 24, 2014 titled "Health Care Reform: Implementation in Minnesota." The topic of the Symposium is law and policy issues relating to the implementation of health care reform in Minnesota. A key goal of the conference is to address real, live, outstanding,...

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Imposed Death 2014: A Conference on Stealth Euthanasia

I am all registered for "Imposed Death 2014:  A Conference on Stealth Euthanasia" on May 2-3, 2014, at the Ramada Plaza Minneapolis.  I hope to gain a better appreciation of these arguments.  Here is a snapshot of the schedule.  There are also some separate workshops and seminars.  9:15-10:00 Alex SchadenbergEuthanasia World Overview10:00-10:45 Ryan VerretPlaying Defense and Offense in Medical Ethics: What's happening in...

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Legal Briefing: Voluntarily Stopping Eating and Drinking

The latest issue of the The Journal of Clinical Ethics is out (Spring 2014, 25(1)).  Included in this issue is an update of my 2011 legal analysis of VSED/VRFF.  Ethically Optimal Interventions with Impaired Patients -- Edmund G. Howe DNR and ECMO: A Paradox Worth Exploring -- Ellen Cowen Meltzer, Natalia S. Ivascu, and Joseph J. Fins Defending the Jurisdiction of the Clinical Ethicist -- John H. EvansCan the...

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Sylvia Sodden - Jewish v. Catholic Family Litigate Life Support in NY

Sylvia Sodden, 78, was raised in an Orthodox Jewish family in Brooklyn but converted to Roman Catholicism when she was just 20 years old.  In 2011, Sodden appointed her godson, Joe Arrigo, 53 as her healthcare proxy.  Sodden is now on life support.  Consistent with her wishes and after consulting with two priests, Arrigo instructed clinicians to withdraw the ventilator.But, on Monday, Sodden's  sister Esther Feigenbaum filed...

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Death Panels: Can We Handle the Truth?

My latest post at BIOETHICS.NET is available here: "Death Panels: Can We Handle the Trut...

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Berkin Elvan - Clinicians Deny Stopping Life Support

During Turkey's Gezi Park protests of last summer, 15-year-old Berkin Elvan was hit on the head by a gas canister as he went to buy bread.  He has spent the past nine months in a coma.  This past week, Elvan died, triggering protests across the country. Demonstrations, which began in İstanbul when news of the teenager's death broke, quickly evolved into anti-government protests across the country.Some political factions have even claimed...

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Conflict Resolution and Bioethics Mediation Training for Healthcare

The JointCommission requires that hospitals explicitly identify processes for resolvingconflicts in health care organizations. Additionally, the field of bioethicsnow endorses Bioethics Mediation as a core competency for ethics consultants. Thistraining provides basicskills for addressing conflict throughout healthcare, and is appropriate foradministrators, physicians, nurses, ethics committee members, in-house legalcounsel, health lawyers, chaplains, social workers, patient advocates, riskmanagers, security staff and others.   Conflict...

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Practically Engaged Bioethics Scholars

I strolled through the Rodin Museum & Gardens this afternoon.  The Gates of Hell struck me differently this time.  Most of the sculpture represents all sorts of chaos and agony.  In contrast, the Thinker (near the top center) is apart and quietly contemplating something.  What does this have to do with practically engaged bioethics scholarship?  I like being an academic.  But this sculpture illustrates something...

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Wisconsin Bill to Eliminate Pregnancy Limitation on Advance Directives

The Marlise Munoz case received such wide and extensive media coverage that it woke up some long dormant and latent dragons.  Specifically, many individuals in other states were surprised to discover that their very own state statutes included precisely the same categorical limitations on advance directives as the Texas Advance Directives Act.Consequently, it is no surprise that some of these states are now considering the elimination of this limitation.  One of these states is Wisconsin.  This week, legislators introduced A.B. 861....

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Health Care Decision-Making and the “F” Word—Futility

I am pleased to be a part of this upcoming webinar from the American Bar Association: "Health Care Decision-Making and the “F” Word—Futility."Wednesday, April 23, 2014, from 1:00 – 2:30 Eastern timePhone: 800-285-2221 and select option “2”Online: http://apps.americanbar.org/cle/programs/t14mfh1.htmlEvent code: CET4MFHRecent cases involving brain dead patients and resulting disputes over continuing organ-sustaining treatments have reignited debate over the appropriate use of medical technologies. The family of Jahi McMath in Oakland, CA, fought...

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Hamline Health Law Rises in Rankings Again

This morning, U.S. News & World Report released its 2015 overall and specialty rankings of law schools.  I was pleased to see that Hamline's healthcare law rank has again gone up (again), now to #15.#1 University of Maryland #2 St. Louis University #3 Case Western Reserve University #3 Loyola University Chicago #5 Boston University #5 Seton Hall University #7 Georgetown University #8 Georgia State University #9 University of Houston #10 Harvard University #10 Indiana University—Indianapolis...

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Kentucky May Be Next State with POLST Statute

Last week, the Kentucky House passed a bill to enact POLST (called MOST).  Now the Senate is considering the bill.  If your state does not yet have a POLST statute (or regulations), check out the brand new POLST Legislative Guide.&nb...

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The Journal of Medicine & Philosophy 39(2) has a great new symposium addressing one potential new tool to improve surrogate decision making.Annette Rid - Will a Patient Preference Predictor Improve Treatment Decision Making for Incapacitated Patients?Annette Rid and David Wendler - Use of a Patient Preference Predictor to Help Make Medical Decisions for Incapacitated PatientsAnnette Rid and David Wendler - Treatment Decision...

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Lorna Baillie, Mistakenly Declared Dead, Suing for £5 Million

Here is yet another case that may further fuel prognostic mistrust when it comes to declaring death.In February 2012, Lorna Baillie suffered a heart attack and was taken to the Edinburgh Royal Infirmary.  Just a few hours later, healthcare workers declared Ms. Baillie dead, and switched off her life-support machines.  But while paying their last respects in a private room, family members were convinced that they saw signs of life.  They...

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New York Criminally Charges Nine for Failing to Connect Ventilator

When healthcare workers make mistakes, even culpable mistakes, they are usually not faced with criminal sanctions.  Maybe they will internal sanctions like staff privilege restrictions, maybe civil liability, and maybe licensing board discipline.  Criminal sanctions are rare.  But it sometimes happens.  Last month, the New York Attorney General charged nine staff members of a nursing home for failing to connect a patient's ventilator, for ignoring alarms, and for covering up the patient's dea...

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"Resurrection" on ABC

I am not sure that this is the type of show we need right now, one that fuels EVEN MORE false hope.  In ABC's "Resurrection" the people of Arcadia, Missouri are forever changed when their deceased loved ones suddenly start to retur...

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37th Annual Health Law Professors Conference

If you are an academic who is teaching or researching in health law, then the 37th Annual Health Law Professors Conference is the conference for you.  It is widely regarded as the single best gathering of academic health lawyers in the world.  (Sorry, AALS, SEALS, APHA, ASBH...).  Plus, this year, it is in San Francisco (June 5-7, 2014).ASLME’s Annual Health Law Professors Conference is intended for professionals who teach law...

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Florida Court DENIES Hospital Request to Override Surrogate

I blogged yesterday about Cape Coral Hospital's petition to override its patient's surrogate and to withdraw the patient's life-sustaining treatment.  The Court denied the petition, ruling that the son was acting as an appropriate surrogate in requesting continued non-palliative treatment. &nb...

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Medical Futility at Yale

I am speaking at Yale Medicine and at Yale Law later this month.  One of the talks is on medical futility.  So, I started brushing up on the local statutory and judicial landscape.  Boy was I surprised to find so many litigated medical futility cases in such a small state.  And the most recent one is against Yale itself.In late 2013, in a 15-page written memorandum, a Superior Court denied Yale's motion to dismiss an intentional...

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Florida Court to Decide Medical Futility Case

Cape Coral Hospital (part of Lee Memorial Health System, near Fort Meyers, Florida) has asked a local court to allow them to remove life-sustaining treatment without the family's consent and over their objections.  Judge Michael T. McHugh may soon adjudicate a case that frequently arises in our nation's hospitals but rarely reaches into a courtroom.  Confidential Party v. Confidential Party, No. 14MH165 (Lee County Circuit Court, Fla.,...

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History of Shared Decision Making

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Farmiloe Campaign against Unilateral DNAR Orders

British actress Sally Farmiloe is campaigning for stricter controls on hospital 'Do No Resuscitate' (DNR) orders after publicly accusing doctors (in the Daily Mail) of deciding not to revive her if her heart failed.  The actress has terminal liver and bone cancer and was admitted to a hospital in London in October.  She was later shocked to discover a DNR order in her medical records - which she did not authori...

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Intensive Care - Absence of Generally Accepted Healthcare Standards

One of the insightful "Murphy's Laws" is Leahy's Law: If a thing is done wrong often enough, it becomes right.This succinctly captures a key legal obstacle to critical care physicians unilaterally refusing life-sustaining treatment deemed inappropriate or non-beneficial.First, the high variability across hospitals, clinicians, and contexts means that it is difficult to know whether a specific surrogate-requested treatment really is contrary to "generally...

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Imposed Death: A Conference on Stealth Euthanasia

The Euthanasia Prevention Coalition, and Human Life Alliance are sponsoring a conference here in Minnesota on May 2-3, 2014, at the Ramada Plaza Minneapolis.  The conference will focus on the expanding threats to human life for patients facing serious health issues, and offering steps to prevent "this creeping stealth euthanasia." Get details and strategies from experienced speakers who have been working in response to this expansion of...

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