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 affirmed, holding that Minn. Stat. § 609.215’s criminalization of speech that “advises” and “encourages” another in taking the other’s life infringes on protected speech and is facially overbroad. 



But the Court of Appeals also held that the record contains sufficient evidence to establish a reasonable probability that the defendants violated the constitutional prohibition on "assisting" suicide.

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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 had not adequately disclosed statistical mortality information of the cancer and thus failed to obtain his informed consent to undergo the treatment.  Arato's wife claimed that had he known the bleak truth regarding his chance for survival Arato would not have sought treatment and, instead would have chosen to die peacefully at home. 



But the jury found in favor of the defendants . The court of appeals reversed and ordered a new trial.  The California Supreme Court reversed, reinstating the defense verdict.



Today, twenty years later, I am optimistic that clinicians have a clearer and stronger duty to inform patients about end-of-life options.  There are new statutes in California and New York.  And the expanded California duty is now being tested in the Hargett v. VITAS case.

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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 motivate better compliance with advance directives.  

The Hallada v. Lakeland case is one instance of increased enforcement of patient rights at the end of life.  [UPDATE] Last week, the 10th Judicial Circuit Court is presently considering the denied the defendants healthcare facilities' motion to dismiss several claims for damages and granted only their motion to dismiss a claim for injunctive relief.

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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 pay only for clinical care that met the newly defined standard of care."  



Dr. Gillick's argument is valid but not sound.  Given extreme variability among critical care clinicians, it seems unlikely any such consensus can be reached anytime soon.  

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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.  

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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 responding to treatment and that the family were informed of end of life path way.  But he admitted failing to inform her daughters of an earlier decision not to resuscitate their mother was an 'omission'.

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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 Policy



Loyola University Chicago School of Law, a well established urban Jesuit law school, is currently seeking candidates to fill its recently created chair in health law and policy, named in honor of law school alumnus and donor Bernard J. Beazley.  This twelve month position will entail an appointment to an endowed chair to be made at the level of full Professor of Law.



The responsibilities of the Bernard J. Beazley Chair include:

1. Scholarly research and publication;


2. Teaching courses in health law and policy and related areas of individual expertise;


3. Participation in faculty governance;


4. Active involvement in student mentoring and counseling;


5. Engagement with faculty on health law and policy matters both within the School of Law and throughout the University;


6. Together with other chairs and senior faculty, providing leadership for integrative research activities; and


7. Significant engagement with academic institutions and professional organizations in health law and policy, including frequent participation in meetings and symposia.

The qualifications required for the Bernard J. Beazley Chair are:

1. Juris Doctor degree (J.D.);


2.  Broad recognition for scholarly distinction in a recognized area of health law and policy;


3.  Established publication record in health law and policy;


4. Clearly developed long term research agenda; and


5. Extensive teaching experience.

Additional valued qualifications include:

1. Significant practice experience in health law and policy or related area;


2. Strong commitment to social justice issues; and


3. History of active engagement with legal practice groups in areas related to health law and policy.

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