Rationing - The Case of NICU and the Place of Cost-effectiveness Thresholds

Julian Savulescu will be delivering the next public lecture at the Australian Centre for Health Law Research:  "Rationing - The Case of NICU and the Place of Cost-effectiveness Thresholds" on May 18.When health professionals are considering whether or not to provide life-sustaining treatment to a critically ill newborn infant, they often consider the best interests of the child. Frequently, they will consult with the infant’s parents, and take...

Read More

Marsala v. Yale New Haven Hospital

The medical futility lawsuit for damages against Yale New Haven Hospital was scheduled for trial next month.  But the case is now stayed while the plaintiffs take up an appeal.The appeal concerns whether plaintiffs can pursue their IIED (intentional infliction of emotional distress) claim.  In other cases across the country, IIED is typically the strongest and most successful claim asserted by the families of patients whose life-sustaining treatment was unilaterally withheld or withdra...

Read More

Oregon's "Death with Dignity" Law: Implementation and Experience (webinar)

Sue Dessayer Porter, MSB '10 will present a webinar for Union - Mt. Sinai, "Oregon's 'Death with Dignity' Law: Implementation and Experience" on Wednesday, May 13 from noon-1 pm ET. Porter serves on the Advisory Board Leadership Council for Compassion & Choices. She has stewarded terminally ill patients through Oregon’s Death with Dignity law as a longtime volunteer and appeared in “How to Die in Oregon,” winner of the 2011 Sundance Film...

Read More

NHS Resuscitation Guidelines - Over-Inclusive?

Apparently, pursuant to new NHS guidance, "in some parts of England, practice nurses have been instructed to cold call patients and fill out an advance care plan for them over the phone."  This seems similar how some US jurisdictions deal with POLST. We criticized this over-inclusive and potentially less-than-thorough approach in last year's POLST Legislative Guide.One health policy analyst commenting on the NHS guidelines, explained "it's a...

Read More

South Carolina Addressing Decision Making for Unbefriended

This session, several states are addressing gaps in how medical treatment decisions are made for patients without surrogates (the "unbefriended").  South Carolina is proposing to add two additional categories of decision makers at the end of its default surrogate list (for a total of 11 categories) .(1) A close friend of the patient who is an adult and reasonably is believed by the health care professional to have a close personal relationship with the patient;(2) A clinical social worker . . . or an individual who is a graduate...

Read More

Over-treatment (video)

...

Read More

Norman Cantor's Plan to Avoid the Ravages of Extreme Dementia

Law professor Norman Cantor has a superb post over at Bill of Health:  "My Plan to Avoid the Ravages of Extreme Dementia."  He defends VSED over some other exit optio...

Read More

Future of End-of-Life Care (NPR)

On Friday, Minnesota Public Radio News' Kerri Miller moderated an hour-long discussion on the future of end-of-life care with three experts:Susan Wolf: McKnight presidential professor of law, medicine and public policy at the University of MinnesotaDr. Glen Varns: Palliative medicine physician at Allina HealthDr. Jacob J. Strand: Director of Symptom Management, Pain and Quality of Life Clinic at M...

Read More

The Unbefriended - NYC HHC Annual John Corser Ethics Conference

The New York City Health and Hospitals Corporation is the largest municipal  health care system in the United States.  This year, its John Corser Ethics Conference is tackling one of the biggest, yet perennially neglected, topics in clinical bioethics: medical decision making for patients without surrogates.The term "unbefriended" describes those persons--regardless of age--who reach the end of life with neither decision-making capacity...

Read More

International Association of Bioethics, 13th World Congress Edinburgh

The 13th World Congress of Bioethics will be in Edinburgh from 14 - 17 June, 2016. &nb...

Read More

Law, Religion, and Health in America

I am looking forward to participating in this conference in a few weeks at Harvard.2015 Annual ConferenceLaw, Religion, and Health in AmericaMay 8 - 9, 2015Conference DescriptionReligion and medicine have historically gone hand in hand, but increasingly have come into conflict in the U.S. as health care has become both more secular and more heavily regulated.  Law has a dual role here, simultaneously generating conflict between religion and...

Read More

Baby F - Oklahoma Supreme Court Requires Clear & Convincing Evidence to Stop Life Support

This week, the Oklahoma Supreme Court issued its opinion in the Baby F case. The court held that for children in DHS custody, Oklahoma courts may authorize the withdrawal of life-sustainingmedical treatment or the denial CPR only after determining by clear and convincing evidence that it is in the best interest of the child to do so.Clear and convincing evidence requires roughly 80% certainty instead of the typical preponderance/probability (>50%) standard in civil law.Facts of the CaseThe 3-month-old baby boy was one of several...

Read More

The Diabolical System of Imposing Death

This Catholic conference in Washington state, next month, sure has a provocative title. Sessions include:The Culture of Death and the Silence of the Church"Deception of “Brain Death” Imposes True Death How the Case of Terri Schiavo Affects us All&nb...

Read More

Atul Gawande in Minnesota

Speaking of Being Mortal: A life-changing conversation with Dr. Atul GawandeFriday, September 18, 20156:30 to 8 p.m. at the St. Paul RiverCentre BallroomMNHPC is pleased to present “Speaking of Being Mortal,” a life-changing conversation with best-selling author Dr. Atul Gawande, moderated by Minnesota Public Radio’s Cathy Wurzer.Registration begins June 15, 2015, check back then for more informati...

Read More

Brain Death & Medical Futility - Empowering Families in the ICU

Patrik Hutzel runs IntensiveCareHotline.com, where they improve the lives of families of critically ill patients in intensive care, so that you can have peace of mind, real power, real control and so that you can influence decision making, even if you’re not a doctor or a nurse in intensive care.I talked with Patrik on a recent episode of the IntensiveCareHotline.com podcast.  Listen to the interview here.  (I also did another podcast back in 2014.)In the interview, Patrik and I explore and discuss recent controversial...

Read More

Current Trends in End-of-Life Medical Treatment (MP3)

This week, I am visiting Southern Illinois University as the John and Marsha Ryan Bioethicist in Residence.  I did two talks in Carbondale and am doing another in Springfield.  I also talked to the local NPR station, about current trends in bio-ethics and end-of-life medical treatment.  A recording is he...

Read More

Patients without Surrogates - Twitter Chat

Check this out on Monday night.  Decision making for the unbefriended is the biggest bioethics issue that too few are talking abo...

Read More

National Healthcare Decisions Day

Tomorrow is National Healthcare Decisions Day.  Do you have an advance directive?  Is is up-to-date with your agent and alternate agent?  If not, get it done tod...

Read More

VSED Podcast on TWIHL

Check out my podcast on VSED as well as others in the new series THE WEEK IN HEALTH LAW.  Each week, health law professors Frank Pasquale and Nicolas Terry bring in a guest to discuss the most pressing issues in Health Law & Poli...

Read More

Limits of Default Surrogate Laws, Importance of Advance Directives

For patients who lose capacity and have no legally appointed surrogate decision maker, most states have laws that specify a hierarchy of persons who may serve as surrogate decision makers by default. But these state "default surrogate consent statutes" vary in their recognition of important relationships beyond the nuclear family, such as friends, more distant relatives, and intimate relationships outside marriage.A research study just published...

Read More

Is International Consensus on Brain Death Achievable?

Commenting on a new study in NEUROLOGY that shows a wide diversity of brain death practice, James Bernat asks "is international consensus on brain death achievable?"Bernat observes: "Worldwide concurrence on death determination criteria can enhance public confidence in physicians’ ability to determine death by eliminating the possibility that patients declared dead in one jurisdiction would be considered alive in another. International...

Read More

Neither Doctors nor Laypersons Understand Brain Death

Here is a good presentation with some disturbing data from the Society of Critical Care Medicine (SCC...

Read More

Toronto Police Criminally Charge Nurse for Stopping Life Support without Consent

Deanna LeblancToronto police have arrested Joanna Flynn (50), a former nurse at Georgian Bay General Hospital for allegedly cutting off a patient’s life support without authorization.  She is charged with manslaughter and with criminal negligence causing death. The victim, Deanna Leblanc (39), died at the hospital on March 2, 2014.  The hospital CEO observed "A criminal charge involving someone at our hospital...

Read More

Lawsuit for Unilateral Withdrawal - King v. Summa Health

A few days ago, the family of Minnie King filed a lawsuit against Summa Health System in Akron, Ohio.  They allege that clinicians at Akron City Hospital "withdrew life-sustaining treatment . . . without consent." The claims are for (1) wrongful death and (2) conscious disregard for the patient's rights and safety.  Importantly, the second claim supports punitive damages. &nb...

Read More

Texas Futility Law - House Committee Hearing Today

Rep. HarlessI recently recapped the several bills introduced that were this session to amend the dispute resolution provisions in the Texas Advance Directives Act.  This morning at 10:30, the House State Affairs Committee will hold a hearing on H.B. 2351 (Harless) which requires hospitals to adopt policies on conflicts of interest and discrimination for their TADA review committees. A recording of the hearing should be posted here lat...

Read More

Has the Pendulum Swung too Far in Favor of Patient Autonomy?

"Institutional Culture and Policies’ Influence on Do Not Resuscitate Decision-Making at the End of Life," online first in JAMA Internal Medicine looks at the difference between (a) hospitals which have policies or a culture that prioritizes patient autonomy with regard to DNAR orders and (b) hospitals where doctors’ recommendations on what might be in patients’ best interests medically hold more sway.Elizabeth Dzeng and colleagues argue that...

Read More

Texas Advance Directives Act: Must a Death Panel Be a Star Chamber?

I just submitted an invited commentary: "Texas Advance Directives Act: Must a Death Panel Be a Star Chamber?"  This is a shorter version of the more exhaustive forthcoming "Texas Advance Directives Act: Almost a Model Dispute Resolution Mechanism for Intractable Medical Futility Dispute...

Read More

Non-beneficial Treatment Policy University Hospitals - Case Medical Center (video)

University Hospitals Case Medical Center recently held a grand rounds to explain its new non-beneficial treatment policy.  Interestingly, the process is more rigorous when clinicians want to withdraw existing treatment than when they want to withhold treatment as non-benefici...

Read More