Terri Schiavo died ten years ago, today, on March 31, 2005, around 10:00 am EST. An earlier court ruling had allowed her husband and legal guardian, Michael Schiavo, to authorize the removal of her artificial nutrition and hydration on March ...
Thứ Ba, 31 tháng 3, 2015
Thứ Hai, 30 tháng 3, 2015
Maine Legislation Would Mandate Written Consent before Stopping Life-sustaining Treatment
Four months ago, I blogged about Simon's Law, a bill that was introduced in Missouri to prohibit the unilateral withholding and withdrawing of life-sustaining treatment from children like Simon Crosier, a baby born with Trisomy 18.The bill would make Missouri a "red light" state like Ontario, Idaho, New York, and Oklahoma. In contrast, California, Texas, and Virginia are "green light" states in that they specifically permit clinicians...
Chủ Nhật, 29 tháng 3, 2015
How do you want to die? A mission to make death part of popular conversation
PBS NewsHour just ran a great 10-minute profile of The Conversation Project. A growing national movement to normalize end-of-life discussions among family and friends has gained traction in recent months. As Medicare considers whether to cover such conversations with physicians, The Conversation Project is highlighting the importance of talking openly about dyi...
Inertia of Clinical Practice: Impact of Tracey on DNACPR Discussions
It has been nearly tenmonths since the UK Court of Appeals handed down itsjudgment in Tracey v. Cambridge UniversityHospitals NHS Foundation Trust. Some predicted that the decision would have "far-reaching implications for clinical practice." But a recent study shows that "national coverage . . . did not lead to any significantdifference in the documentation of DNACPR discussions." Indeed,"very few clinicians . . . were even aware of the case."The authors remarked on the "inertia of clinicalpractice"...
Thứ Bảy, 28 tháng 3, 2015
Intensive Care Hotline Resource for Families of Critically Ill Patients
Most of my blogging on this site, as well as my articles and book chapters, and all concern legal rights and duties concerning medical treatment at the end of life. But most of the communication, negotiation, and mediation about end-of-life treatment conflicts never gets (or needs to get) framed in legal terms. Disputes are usually resolved way upstream. Most hospitals have ethics consults, ethics committees, ombudsmen, patient advocates, and/or other resources. One external resource for families of critically...
Thứ Sáu, 27 tháng 3, 2015
$1 Million Lawsuit over Unilateral DNR Order - Luong v. Toronto East General Hospital
Robert Cribb at the Toronto Star has been a diligent and articulate investigative reporter covering end-of-life medical treatment disputes. This week, he reports on a new lawsuit filed by the family of Canh Luong against Toronto East General Hospital.94-year-old Luong was admitted to TEGH in September 2014. While clinicians recommended comfort measures, that plan was rejected by her family. But by October 2014, hospital physicians...
Lisa Avila Family Now Accepts Death Diagnosis, Agrees to Stop Physiological Support
It looks like the brain death dispute between the family of Lisa Avila and Anaheim Regional Medical Center is coming to a consensual conclusion.After obtaining a TRO, the family was able to bring in their own neurologist. Like the ARMC physicians, the independent neurologist did not detect any brain activity. The family now plans to take Avila off of life support around 5 p.m. Friday. (ABC News)The family reported on its fundraising website:...
Thứ Năm, 26 tháng 3, 2015
Biosecurity in a Globalised World: The Adoption of the Revised International Health Regulations – 10 Years On
Biosecurity in a Globalised World: The Adoption of the Revised International Health Regulations – 10 Years OnIn 2015 it will be 10 years since the adoption of the revised International Health Regulations (IHR). To mark this important anniversary, QUT’s Australian Centre for Health Law Research is pleased to invite you to Biosecurity in a Globalised World: The Adoption of the Revised International Health Regulations – 10 Years On.The conference will...
Dissecting the Ethics of Organ Donation - 2nd Annual Islamic Bioethics Workshop
The Initiative on Islam and Medicine’s (II&M) 2nd Annual Islamic Bioethics Workshop, titled “Dissecting the Ethics of Organ Donation,” will be held June 5-7, 2015, at the University of Chicago.Co-sponsored by the American Islamic College, the 3-day workshop will provide an in-depth conceptual introduction to the field of Islamic bioethics and examine the practical and theological ethics of organ donation in Muslim contexts and from an Islamic...
Thứ Tư, 25 tháng 3, 2015
Court Orders Hospital to "Treat" Dead Woman - Avila v. ARMC
Following the procedural path set by the Jahi McMath case in 2013, the family of Lisa Avila has obtained a TRO "precluding" Anaheim Regional Medical Center from "removing Lisa Avila from the ventilator or ending any of the current treatment." The family is going to get an "independent" exam to confirm the diagnosis of death by neurological criter...
Thứ Ba, 24 tháng 3, 2015
Medical Futility Lawsuit Proceeds against Yale - Marsala v. Yale New Haven Hospital
In 2008, I reviewed all the medical futility lawsuits that I could find. I looked at both ex ante cases (for injunctions) and ex post cases (for damages). With respect to the ex post cases, I concluded that the single most successful theory has been for emotional distress (IIED or NIED).Consistent with my findings, in late 2013, the Connecticut Superior Court denied Yale New Haven Hospital's motion to dismiss an intentional infliction of emotional distress (IIED) claim brought by the family of Helen Marsala. (I blogged about...
California Lawsuit for Not Honoring POLST
The family of Mary Virginia Schuller has just filed a lawsuit in Los Angeles Superior Court against a long term care facility for, among other things, failing to honor her June 2014 POLST. Administratively, CMS has already concluded that the facility violated Ms. Schuller's rigths under Medicare/Medicaid Conditions of Participation. The civil damages claims are for:ELDER ABUSE & NEGLECTNEGLIGENCENEGLIGENT HIRING, SUPERVISION, & RETENTIONVIOLATION OF RESIDENTS RIGHTSNEGLIGENT INFLICTION OF EMOTIONAL DISTRESSWRONGFUL...
AALS Section on Disability Law Call for Papers/Presentations for 2016 Annual Meeting
The AALS Section on Disability Law issued the following call for papers and presentations for the 2016 AALS Annual Meeting to be held in New York, New York, January 6-9, 2016. Selected papers will be published in the Journal of Legal Medicine.Program titleThe Wounded Warrior Comes Home: Exploring the Impact of Disabled Veterans on Disability, Health, and Other Law and Policy.Program DescriptionAbout a century ago, returning war veterans with disabilities had a profound impact on both cultural and legal attitudes toward disability, shifting us from...
Very Sick Children: Treatment at Any Cost?
The Royal College of Paediatrics and Child Health (RCPCH) has just published a new framework to help doctors make tough decisions on end of life care for children and young people. The new framework sets out an ethical and legal framework for when it can be considered no longer in the best interests of the child to give life sustaining treatment. Specifically, the framework provides three sets of circumstances when limiting treatment can be...
Thứ Hai, 23 tháng 3, 2015
Schiavo 10 Years Later (conference)
Coming up next month in Miami: "Schiavo: 10 Years Later" - at the Florida Bioethics Network and University of Miami 23rd Annual Bioethics Conference on April 17, 2015.Other sessions address The Future of Hospital Ethics CommitteesEthics, Child Safety and Gender Identity DysphoriaIncapacitated and Alone: Social Workers as ProxiesNursing in the Indian Health Service: Managing Ethical Challen...
Chủ Nhật, 22 tháng 3, 2015
Utah Bill Assures Coverage for Terminally Ill
Utah S.B. 271 has passed both houses of the state legislature. It prohibits denial of coverage under a health benefit plan because of life expectancy or a terminal condition.The bill mandates that a health benefit plan may not deny coverage for medically necessary treatment if: (1) it is prescribed by a physician; (2) it is agreed to by the patient/surrogate, and (3) the patient/surrogate is fully informed regarding life...
Thứ Bảy, 21 tháng 3, 2015
Hospital Agrees to 4 More Days of Physiologic Support for Dead Woman
Earlier this week, Anaheim Regional Medical Center diagnosed Lisa Avila, 37, and the mother of seven, as dead (by neurological criteria). Accordingly, consistent with California law and the medical standard of care, the hospital told the family that it would remove physiologic support at 4 p.m. on Friday.But Avila's family objected, insisting that she is alive and does not want to give up. The hospital has now agreed to further accommodate the family until noon Tuesday. (CBS News)&nb...
Living the Best Life Possible: Doctor and Patient Conversations About Serious Illness and Mortality (Video)
This week, Public Radio International "The World," WGBH, and Harvard T.H. Chan School of Public Health presented "Living the Best Life Possible: Doctor and Patient Conversations About Serious Illness and Mortality." The panel in this one hour video includes Atul Gawande and Susan Block.Many Americans may confront illnesses so serious that they are life threatening. These diagnoses may come with treatment attempts and hospital stays. What they may not include are honest and open conversations about the final stages of life. How might the patient...
Thứ Sáu, 20 tháng 3, 2015
Legal Briefing: Coerced Treatment and Involuntary Confinement for Contagious Disease
My latest “Legal Briefing” column is now up over at the Journal of Clinical Ethics. "Legal Briefing: Coerced Treatment and Involuntary Confinement for Contagious Disease" covers recent legal developments involving coerced treatment and involuntary confinement for contagious disease. Recent high profile court cases involving measles, tuberculosis, human immunodeficiency virus, and especially Ebola, have thrust this topic back into the bioethics...
Thứ Năm, 19 tháng 3, 2015
Another California Brain Death Dispute - Lisa Avila
Last month, Lisa Avila went to Anaheim Regional Medical Center while pregnant with her eighth child. Her family says that the hospital sent her home. A day later, Avila slipped into a coma due to an undiagnosed ectopic (tubal) pregnancy. (Family website)In the past few days, hospital clinicians have determined that Avila is now brain dead. Consequently, they have told the family that they are planning to remove Avila's physiologic support...
Higher Brain Death - Gravestones of Schiavo and Cruzan
I just finished the second edition of Veatch and Ross's excellent Transplantation Ethics (Georgetown 2015). The first several chapters review competing definitions of death. Among other arguments, the authors defend a higher brain standard, an argument that has not had much currency the past decade. This reminded me of the gravestones of Nancy Cruzan and Theresa Schiavo. Both indicate that the women "died" as of the point...
Thứ Tư, 18 tháng 3, 2015
The Art of Dying (NYC April 24-26, 2015)
The Art of Dying is the 5th installment of a conference that brings together important innovators, researchers and authors in the fields of death and dying, including practitioners in the areas of palliative and hospice care. Many are trained in modern medicine and work directly with the dying or bereaved. Others speak from the wisdom of traditional teachings, while still others share with us their own deeply personal accounts.This conference presents a unique opportunity for all those seeking to better understand, acknowledge and ultimately embrace...
Thứ Ba, 17 tháng 3, 2015
Minnesota Compassionate Care Act of 2015 Will Legalize Aid in Dying
Minnesota Senators Eaton, Pappas, Dibble, and Marty have just introduced the Minnesota Compassionate Care Act of 2015 (SF 1880). Likelegislation now under consideration in more than 20 states, this bill wouldlegalize physician aid in dyi...
Anatomy Bequest Program
I just submitted my donation authorization to the Anatomy Bequest Program at the University of Minnesota. The bequest program is a whole body donation program whose purpose is to support medical research and education for health professionals by facilitating the donation process. Anatomical donation supports high quality education for future health professionals and continued advancements in medical care through research. The program has...
Thứ Hai, 16 tháng 3, 2015
Texas Futility Law - Stakeholder Talks
Over the past few days, I have summarized a number of new Texas bills aimed either at improving or at eliminating the dispute resolution provisions in the Texas Advance Directives Act. It was encouraging to see that there have been some efforts to discuss these issues among relevant stakeholders - as there was back in the early years of TADA. But it is unclear (here too) whether those efforts are going to be successful. &nb...
Thứ Bảy, 14 tháng 3, 2015
Texas Advance Directives Act - More 2015 Amendments
A few days ago, I blogged about S.B. 1163. This week, Texas legislators introduced a number of other bills directed at amending the dispute resolution provisions of the Texas Advance Directives Act. Here is a quick run down:H.B. 2351 (Harless) requires review committees to adopt two types of policies: (1) "to prevent financial and health care professional conflicts of interest" and (2) "to prohibit consideration of a patient ’s permanent physical or mental disability during a review . . . unless the disability is...
Thứ Năm, 12 tháng 3, 2015
Texas Advance Directives Act - 2015 Amendments
House and Senate bills both to improve and to eliminate the dispute resolution provisions in the Texas Advance Directives Act have been introduced in every Texas legislative session since 2003. The first such bill in the 2015 session was introduced this week. Senator Kelly Hancock has introduced S.B. 1163. Senator Hancock is described as pro-life and defending core conservative values. Consequently, it is no surprise...
Thứ Tư, 11 tháng 3, 2015
"We Know How This Ends: Living While Dying" - Book Launch Event
On Wednesday, March 25, from 7:00 to 8:30 PM, Minnesota Public Radio is holding a live and free event at the University of St. Thomas to celebrate the publication of We Know How This Ends: Living while Dying.We Know How This Ends details discoveries by authors Bruce H. Kramer and Cathy Wurzer as they embarked on a journalistic project to document Kramer's struggle with ALS. What began as a series of interviews on the subject of a...
Thứ Ba, 10 tháng 3, 2015
2016 US News & World Report - Best Health Law
This morning, US News & World Report issued its 2016 rankings of all law schools and law school programs. Here is the list of health law. This is the third year in a row, that Hamline has moved up, now to No. 13.#1 St. Louis University#2 University of Maryland (Carey)#3 Georgia State University#4 Georgetown University#5 ...
Thứ Hai, 9 tháng 3, 2015
Healthcare for Undocumented Immigrants
The esteemed bioethics think tank, the Hastings Center, recently identified "eight news stories to watch in 2015." These are topics that the staff determined are developing and therefore "certain or likely to have impact in the year ahead."Right near the top of the list, the Hastings Center encourages its readers to "look for increased attention to solutions to closing gaps in access to health care for undocumented immigrants on grounds...
Chủ Nhật, 8 tháng 3, 2015
Sixth International Symposium on Brain Death
The VI International Symposium on Brain Death and Disorders of Consciousness will be held in Havana, Cuba, on December 1-4, 2015. Details he...
Thứ Bảy, 7 tháng 3, 2015
VSED: Real Alternative to Aid in Dying
Those calling for the legalization of aid-in-dying often highlight the necessity and importance of legalizationthrough denigrating alternative ways to hasten death. A particularly favorite target is VSED (voluntarily stopping eating and drinking).In the Telegraph, this week, Bruce Fogle writes about his motherAileen and her decision to die in Ontario. “You won’t give me anything so I have decided to stop eating and drinking. What do you...
Thứ Sáu, 6 tháng 3, 2015
Life support wards reviewed to "kick out the bludgers"
The Department of Social Services has launched ablueprint to "stop hospital patients from bludging on life support." Australian satire. But the column could have almost been a newssto...
Thứ Năm, 5 tháng 3, 2015
Schizophrenic with Gangrenous Leg Allowed to Refuse Amputation
Even today, two of the best U.S. cases for illustrating the principles of patient decision making capacity are almost 40 years old: Lane v. Candura (Mass. 1978) and DHS v. Northern (Tenn. 1978). Both cases concern women with gangrenous feet who refuse life-saving amputation. The stakes are the same in both cases. But one only woman really understands her clinical situation. Her decision was honored.A recent case from the UK...
Thứ Ba, 3 tháng 3, 2015
McMath Family Sues Oakland Children's Hospital; Alleges Jahi is Alive
The case of Jahi McMath is infamous around the world for the remarkable claim that she is no longer dead. In December 2013, federal and state courts in California determined that Jahi was legally dead. While the courts issued temporary restraining orders to preserve the status quo (continued physiological support) pending their rulings on pending motions, both courts ultimately refused to order the hospital or its clinicians to continue administering medical interventions to Jahi.Since December 2013, the family has twice indicated that...
Brain Death & Futility at ICCEC
I blogged about the upcoming ICCEC this weekend. Here are a few sessions that caught my eye.Panel - Comparing Israeli and American Experiences: Families’ requests for continued physiologic support of patients deemed dead by neurological criteria -- Anne Lederman Flamm, Jonathan CohenDo Everything!” – New aspects of a never-ending story -- Kurt W SchmidtDecision-Making for the Unbefriended Patient: A model approach facilitated by the Ethics Consult Service -- Joan Henriksen HellyerPhysician Attitudes Toward Proactive,...
Thứ Hai, 2 tháng 3, 2015
Left Out: Undocumented Immigrants and the American Health Care System
Hamline University is hosting a compelling CLE event on March 25: "Left Out: Undocumented Immigrants and the American Health Care Syste...
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