Minnesota Appeals Ruling that Assisted Suicide Statute Is Unconstitutional

Minnesota's criminal case against the Final Exit Network is proceeding to the court of appeals.  Back at the Dakota County criminal court in December, FEN argued that while the state may bar someone from “assisting” a suicide, it is unconstitutional for the state to ban merely “advising” or “encouraging” a suicide — as stated in the Minnesota statute — because that is pure speech.  



In March, Judge Karen Asphaug found Minnesota’s law  unconstitutionally overbroad. She also narrowed the construction of the term “encouraging” to include only physical acts or language that promote or urge someone to commit suicide.  Based on that finding, Asphaug dismissed charges against the group’s former president, Thomas Goodwin, but kept most of the charges against the other defendants intact.



Dakota County Attorney James Backstrom said his office will not appeal Goodwin’s dismissal, but will contest the ruling as it relates to the group itself and to defendants Lawrence Egbert and Roberta Massey.

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Clinicians Ignore Patients' EOL Preferences

In an alarming new report in
JAMA Internal Medicine, researchers found that clinicians not only fail to
solicit patient treatment preferences at end-of-life, but even when those preferences are recorded, agreement between patients'
expressed preferences for EOL care and documentation in the medical record was
only 30%.  I address this from a legal perspective in this forthcoming law review article.

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New Hospital Inspection Report Database by AHJC

A few months ago, I blogged about ProPublica's new tool for searching nursing home inspection reports.  Now, the Association of Health Care Journalists has launched a new website that makes federal hospital inspection reports easier to access, search and analyze.  



The new site includes details about deficiencies cited during complaint inspections at acute-care and critical access hospitals throughout the United States since Jan. 1, 2011.  This effort follows years of advocacy by AHCJ to encourage federal officials to publish this information electronically. Until now, this information has only been available through Freedom of Information Act requests – and only in paper form. 

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2014 World Federation Right to Die Societies (WFRTD) 20th Biennial Conference

Final Exit Network, host for the World Federation Right to Die (WFRTD) Societies Meeting, has announced the venue for the 2014 World Federation 20th Biennial Conference.  The date of the conference is September 17 to 21, 2014, Wednesday through Sunday, and it will be held at the Embassy Suites Downtown/Lakefront Hotel, Chicago, Illinois.



The conference venue is the flagship hotel of U.S. Embassy Suites Hilton properties, an all-suites hotel with a sophisticated design concept and spectacular views of Chicago. All suites have a living room/work area, a wet bar, microwave, and refrigerator and two 37-inch TVs, one in the living room and one in the bedroom.  A full hot and cold breakfast and evening reception are included in the price of the room. 



Final Exit Network, has secured an excellent price with considerable savings for early registration — $190 per night for early hotel registration. Conference registration will be $325 for early registration.  Early conference registration will open June 2013; hotel registration opens September 2013.  



The FEN WF conference planning committee is creating an inspiring schedule with world-class speakers in the RTD movement.  With the theme “Dignity, Control, Choice – Around the World,” the committee is focusing on leaders who work on the front lines of legal and philosophical right to die issues throughout the world.  



Delegates will join FEN hosts to share the latest news, will have the opportunity to network with each other, and will work together to promote the agendas of RTD societies around the world.  Everyone is invited and welcome to join Final Exit Network hosts and World Federation delegates.  

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National Public Health Week

The first week of April is National Public Health Week.  Paradigm public health issues include tobacco, obesity, and diabetes.   But many of the end-of-life issues (like persistently low rates of ACP) discussed on this blog are also public health issues.  They affect giant portions of the population, can be prevented, and can be addressed through community-wide interventions.

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Newsome v. Gunnels - Clinicians Win Medical Futility Case

A few weeks ago, the Alabama Supreme Court affirmed summary judgment in favor of a clinician in a medical futility dispute.  The parents of twins born at 22.5 weeks alleged that clinicians failed to undertake medical effort to save the babies or prevent their delivery.  



The court did not issue a written opinion.  But it appears that the plaintiffs attempted to assert only a claim for intentional infliction of emotional distress (often not a bad strategy in such cases).  The defendants argued that this was really a medical malpractice case, requiring expert evidence that the plaintiffs never supplied.  Indeed, it may have been difficult for plaintiffs to find an expert to testify that the babies were viable and could have survived despite their extreme prematurity.



Here is the statement of facts from the plaintiffs' opening appellate brief.



Expecting twin babies, the Plaintiffs, Burton and Regina Newsome, chose St. Vincent's Hospital for the delivery, and the OB/GYN practice, with which Defendant Jeffrey Gunnells is associated, as Regina Newsome's doctor.  Before the birth, however, the individual doctor, whom the parents had chosen, suffered a death in the family, and they were re-assigned to the Defendant.



Regina Newsome is from Uzbekistan and has a strong accent. Upon meeting her, the Defendant abruptly asked her what her religion was.  Although a practicing Christian, her first response was that she is “half-Muslim,” ethnically-speaking. The Defendant's immediate response was negative, and he would not treat her.  She was assigned to a third doctor within the practice who was willing to treat her. 



Not long afterward, when she was between 22 and 23 weeks pregnant, Mrs. Newsome began to leak amniotic fluid, and, although her regular doctor told her this was normal, three days later, she was rushed to the St. Vincent's emergency room--where the Defendant was the doctor on call. 



The Defendant told the parents that their babies were dead and that nothing could be done.  Despite Mrs. Newsome's request, he refused to call in the first doctor (who had since returned to practice after his family tragedy). After four hours of labor, in which the Defendant treated Mrs. Newsome disrespectfully and without regard for the dire nature of the events, the babies were born alive. 



Despite the fact that they were clearly alive, crying and responding, the Defendant failed or refused to provide any medical care to the twin babies. Plaintiff Regina Newsome had begged Dr. Gunnels to call in the Neonatologists prior to giving birth to try and save the babies. The babies were never cleaned up but, instead, left to die before their parents' eyes. For over four hours more, the babies cried, with no assistance from the Defendant, dying there in the room with their distraught and bewildered parents.

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VSED in N.Y. Times

I was pleased to see the following brief commentary printed in yesterday's New York Times.

There is a “better way to die,” and it is legal in all 50 states. It is commonly called Voluntary Stopping of Eating and Drinking or Patient Refusal of Nutrition and Hydration. My mother chose this way to end her life when she was informed that her chemotherapy and radiation treatment for oral cancer had failed and she faced a death marked by pain and occlusion of her windpipe by the tumor that grew in her jaw. She was depressed when she was told her prognosis, but her demeanor reversed when she took control of her life and decided to die on her own terms, without having to suffer the final stages of her disease.

She decided to stop eating and drinking completely when she learned that hunger and thirst abate after only a day or two and there is no additional pain. She received visitors and dozed off and on for 10 days; on the 11th day she became less responsive, and on the 12th day she died peacefully.

The question is: Why don’t doctors inform patients of this option?

SUSAN SCHAFFER

Durham, N.C.

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