Digital Commons Network^™

The Growing Power Of Healthcare Ethics Committees Heightens Due Process Concerns, Thaddeus Mason Pope

Faculty Scholarship

Complex ethical situations, such as end-of-life medical treatment disputes, occur on a regular basis in healthcare settings. Healthcare ethics committees (HECs) have been a leading dispute resolution forum for many of these conflicts. But while the function of HECs has evolved from mediation to adjudication, the form of HECs has not evolved to adapt to this expanded and more consequential function.

HECs are typically multidisciplinary groups comprised of representatives from different departments of the healthcare facility: medicine, nursing, law, pastoral care, and social work, for example. HECs were established to support and advise patients, families, and caregivers as they work …

Clinicians May Not Administer Life-Sustaining Treatment Without Consent: Civil, Criminal, And Disciplinary Sanctions, Thaddeus Mason Pope

Faculty Scholarship

Both medical and legal commentators contend that there is little legal risk for administering life-sustaining treatment without consent. In this Article, I argue that this perception is inaccurate. First, it is based on an outdated data set, primarily damages cases from the 1990s. More recent plaintiffs have been comparatively more successful in establishing civil liability. Second, the published assessments focus on too-limited data set. Even if the reviewed cases were not outdated, a focus limited to civil liability would still be too narrow. Legal sanctions have also included licensure discipline and other administrative sanctions. In short, the legal risks of …

Standards For Health Care Decision-Making: Legal And Practical Considerations, A. Kimberley Dayton

Faculty Scholarship

This Article explores the guardian’s role in making, or assisting the ward to make, health care decisions, and provides an overview of existing standards and tools that offer guidance in this area. Part II outlines briefly the legal decisions and statutory developments assuring patient autonomy in medical treatment, and shows how these legal texts apply to and structure the guardian’s role as health care decision-maker. Part III examines the range of legal and practical approaches to such matters as decision-making standards, determining the ward’s likely treatment preferences, and resolving conflicts between guardians and health care agents appointed by the ward. …

Thinking Locally: Law, Aging And Municipal Government: Findings From A National Survey, A. Kimberley Dayton, Israel (Issi) Doron

Faculty Scholarship

Municipal law, which has been largely ignored in the body of elder-rights scholarship, often plays a far more important role in the everyday lives of older persons than the principally aspirational concepts of international law. Accordingly, this article examines how well modern cities have fulfilled their potential role in assuring the civil and human rights of older persons. The author concludes, based on the results of a national study, that local law is not currently fulfilling its potential as a means to expand the rights of older citizens. Few cities across the country appear to have taken more than minor …

Municipal Elder Law: A Minnesota Perspective, A. Kimberley Dayton, Israel (Issi) Doron

Faculty Scholarship

The field of elder law has developed dramatically over the past several decades and is primarily regarded as a creature of state and federal law. This area of law will be of paramount importance in the coming years as the elderly population continues to increase dramatically. Indeed, nearly every community in the United States will undoubtedly be impacted in some way by the influx of older residents. Notably, however, the effect of an aging society will impact each local community differently. For these reasons, Professors Kimberly Dayton and Israel (Issi) Doron sought to examine the role that municipal elder law …

Voluntarily Stopping Eating And Drinking: A Legal Treatment Option At The End Of Life, Thaddeus Mason Pope

Faculty Scholarship

Despite the growing sophistication of palliative medicine, many individuals continue to suffer at the end of life. It is well settled that patients, suffering or not, have the right to refuse life-sustaining medical treatment (such as dialysis or a ventilator) through contemporaneous instructions, through an advance directive, or through a substitute decision maker. But many ill patients, including a large and growing population with advanced dementia who are not dependent upon life-sustaining medical treatment, do not have this option. They have the same rights, but there is simply no life-sustaining medical treatment to refuse.

Nevertheless, these patients have another right, …

The Uses And Misuses Of Statistical Proof In Age Discrimination Claims, Thomas Tinkham

Faculty Scholarship

When it comes to statistics, age discrimination is different than other forms of discrimination. In most discrimination cases we can take the protected population and make appropriate adjustments for necessary characteristics like education and compare the results to the other employee groups.

With age discrimination this method does not work. It doesn’t work because the normal patterns of aging and promotion or wage increase distort the statistical result. Employees typically are promoted more quickly and receive the highest percentage wage increases in early years. However, they generally retain those benefits for life. Employees reach a high point in their careers …

The Accidental Elder Law Professor, A. Kimberley Dayton

Faculty Scholarship

This Article discusses my somewhat unusual and erratic path to becoming an Elder Law professor. My story, told more or less in chronological order, is a first-person narrative of one woman’s journey to achieve, if not academic renown, then at least personal satisfaction in the realm of the legal academy. It does not aspire to convey ponderous wisdom about the best way to teach Elder Law or the importance of scholarly productivity as a measure of one’s legitimacy. On the contrary, I hope the Article will illustrate that, in the same way the field of Elder Law has grown and …

Medical Futility Statutes: No Safe Harbor To Unilaterally Refuse Life-Sustaining Treatment, Thaddeus Mason Pope

Faculty Scholarship

Over the past fifteen years, a majority of states have enacted medical futility statutes that permit a health care provider to refuse a patient's request for life-sustaining medical treatment. These statutes typically permit the provider to unilaterally stop LSMT where it would not provide significant benefit or would be contrary to generally accepted health care standards. But these safe harbors are vague and imprecise. Consequently, providers have been reluctant to utilize these medical futility statutes.

This uncertainty probably cannot be reduced. Consensus on substantive measures of medical inappropriateness has proven unachievable. Only a purely process-based approach like that outlined in …

Terminal Decisions: Landmark Cases In The Path Toward Ethical End-Of-Life Care, Phebe Saunders Haugen

Faculty Scholarship

This brief article discusses the history of end-of-life care from a legal perspective. The article highlights important cases in Minnesota.