Law Commons^™

Feigned Consensus: Usurping The Law In Shaken Baby Syndrome/Abusive Head Trauma Prosecutions, Keith A. Findley, D. Michael Risinger, Patrick D. Barnes, Julie A. Mack, David A. Moran, Barry C. Scheck, Thomas L. Bohan

Articles

Few medico-legal matters have generated as much controversy--both in the medical literature and in the courtroom--as Shaken Baby Syndrome (SBS), now known more broadly as Abusive Head Trauma (AHT). The controversies are of enormous significance in the law because child abuse pediatricians claim, on the basis of a few non-specific medical findings supported by a weak and methodologically flawed research base, to be able to “diagnose” child abuse, and thereby to provide all of the evidence necessary to satisfy all of the legal elements for criminal prosecution (or removal of children from their parents). It is a matter, therefore, in …

Medical Malpractice And Black-Box Medicine, W. Nicholson Price Ii

Book Chapters

The explosive proliferation of health data has combined with the rapid development of machine-learning algorithms to enable a new form of medicine: “black-box medicine.” In this phenomenon, algorithms troll through tremendous databases of health data to find patterns that can be used to guide care, whether by predicting unknown patient risks, selecting the right drug, suggesting a new use of an old drug, or triaging patients to preserve health resources. These decisions differ from previous data-based decisions because black-box medicine is, by its nature, opaque; that is, the bases for black-box decisions are unknown and unknowable.

Black-box medicine raises a …

Shaken Baby Syndrome, Abusive Head Trauma, And Actual Innocence: Getting It Right, Keith A. Findley, Patrick D. Barnes, David A. Moran, Waney Squier

Articles

In the past decade, the existence of shaken baby syndrome (SBS) has been called into serious question by biomechanical studies, the medical and legal literature, and the media. As a result of these questions, SBS has been renamed abusive head trauma (AHT). This is, however, primarily a terminological shift: like SBS, AHT refers to the two-part hypothesis that one can reliably diagnose shaking or abuse from three internal findings (subdural hemorrhage, retinal hemorrhage, and encephalopathy) and that one can identify the perpetrator based on the onset of symptoms. Over the past decade, we have learned that this hypothesis fits poorly …

Malpractice Suits And Physician Apologies In Cancer Care, Eugene Chung, Jill R. Horwitz, John A.E. Pottow, Reshma Jagsi

Articles

Conside the following case: The patient is a 44-year-old woman who presents for radiation treatment of an isolated locoregional recurrence of breat cancer in her chest wall, 3 years after undergoing masectomy. At the time of diagnosis, she had T2N2M0 disease, with four of 15 lymph nodes involved with tumor. She received a masectomy with negative margins and appropriate chemotherapy, but none of her physicians talked to her about postmasectomy radiation therapy, which would clearly have been indicated to reduce her risk of locoregional failure and would have been expected to improve her likelihood of survival. She asks the radiation …

The Multiple Common Law Roots Of Charitable Immunity: An Essay In Honor Of Richard Epstein's Contributions To Tort Law, Jill R. Horwitz

Articles

Professor Epstein has long promoted replacing tort-based malpractice law with a new regime based on contracts. In Mortal Peril, he grounded his normative arguments in favor of such a shift in the positive, doctrinal history of charitable immunity law. In this essay, in three parts, I critique Professor Epstein’s suggestion that a faulty set of interpretations in charitable immunity law led to our current reliance on tort for malpractice claims. First, I offer an alternative interpretation to Professor Epstein’s claim that one group of 19th and early 20th century cases demonstrates a misguided effort to protect donor wishes. Rather, I …

Jesting Pilate, Carl E. Schneider

Articles

I have two goals this month. First, to examine a case that's in the news. Second, to counsel skepticism in reading news accounts of cases. Recently, I was talking with an admirable scholar. He said that transplant surgeons sometimes kill potential donors to obtain their organs efficiently. He added, "This isn't just an urban legend - there's a real case in California." A little research turned up California v. Roozrokh. A little Googling found stories from several reputable news sources. Their headlines indeed intimated that a transplant surgeon had tried to kill a patient to get transplantable organs. CNN.com: …

Can Glucksberg Survive Lawrence? Another Look At The End Of Life And Personal Autonomy, Yale Kamisar

Articles

In Washington v. Glucksberg, the Court declined to find a right to physician-assisted suicide ("PAS") in the Constitution. Not a single Justice dissented. One would expect such a ruling to be quite secure. But Lawrence v. Texas, holding that a state cannot make consensual homosexual conduct a crime, is not easy to reconcile with Glucksberg. Lawrence certainly takes a much more expansive view of substantive due process than did Glucksberg. It is conceivable that the five Justices who made up the Lawrence majority-all of whom still sit on the Court-might overrule Glucksberg. For various reasons, …

Drugged, Carl E. Schneider

Articles

The Supreme Court's recent decision in Gonzales v. Oregon, like its decision last year in Gonzales v. Raich (the "medical marijuana" case), again raises questions about the bioethical consequences of the Controlled Substances Act. When, in 1970, Congress passed that act, it placed problematic drugs in one of five "schedules," and it authorized the U.S. attorney general to add or subtract drugs from the schedules. Drugs in schedule II have both a medical use and a high potential for abuse. Doctors may prescribe such drugs if they "obtain from the Attorney General a registration issued in accordance with the …

Benumbed, Carl E. Schneider

Articles

I originally intended to write a column on tort liability and research ethics, and I still plan to do so. But this column is a cri de coeur as I finish another semester teaching law and bioethics. This year, I asked with growing frequency, urgency, and exasperation, "Must law's reverence for autonomy squeeze out the impulse to kindness? Where is the beneficence in bioethics?" These questions assail me every term. Why? Consider Steele v. Hamilton County Community Mental Health Board. Mr. Steele was involuntarily "hospitalized after his family reported that he was 'seeing things and trying to fight imaginary …

Genetics And Artificial Procreation In The U.S.A., Carl E. Scheider, Lynn Wardle

Book Chapters

We national reporters have been asked to provide in a few pages such a range of information about the law and practice of medicine generally, genetic and artificial reproductive techniques specifically, and related family law and human rights issues that probably no country's reporter could pretend to have succeeded. We reporters for the United States, particularly, must stress the limitations of our report at the outset. It is difficult to summarize the American law and practice because they are so extraordinarily various and dynamic. There are several reasons for this, most of which will in uncanny ways confirm many of …

Experts, Carl E. Schneider

Articles

George Bernard Shaw famously said that all professions are conspiracies against the laity. Less famously, less elegantly, but at least as accurately, Andrew Abbott argued that professions are conspiracies against each other. Professions compete for authority to do work and for authority over work. The umpire in these skirmishes and sieges is the government, for the state holds the gift of monopoly and the power to regulate it. In Abbott's terms, "bioethics" is contesting medicine's power to influence the way doctors treat patients. If it follows the classic pattern, bioethics will solicit work and authority by recruiting government's power. A …

On The Meaning And Impact Of The Physician-Assisted Suicide Cases, Yale Kamisar

Book Chapters

I read every newspaper article I could find on the meaning and impact of the U.S. Supreme Court's June 1997 decisions in Washington v Glucksberg and Vacco v Quill. I came away with the impression that some proponents of physician-assisted suicide (PAS) were unable or unwilling publicly to recognize the magnitude of the setback they suffered when the Court handed down its rulings in the PAS cases.

The Road To Glucksberg, Carl E. Scheider

Book Chapters

No abstract provided.

Making Biomedical Policy Through Constitutional Adjudication:The Example Of Physician-Assisted Suicide, Carl E. Scheider

Book Chapters

Throughout most of American history no one would have supposed biomedical policy could or should be made through constitutional adjudication. No one would have thought that the Constitution spoke to biomedical issues, that those issues were questions of federal policy, or that judges were competent to handle them. Today, however, the resurgence of substantive due process has swollen the scope of the Fourteenth Amendment, the distinction between federal and state spheres is tattered, and few statutes escape judicial vetting. Furthermore, Abraham Lincoln's wish that the Constitution should "become the political religion of the nation" has been granted. "We now reverently …

Hard Cases, Carl E. Schneider

Articles

Robert Latimer was born in 1953 on a farm on the prairies of Saskatchewan and grew up to own a 1,280-acre farm. In 1980 he married, and that year Tracy, the first of four children, was born. During her birth, Tracy's brain was terribly damaged by lack of oxygen, and severe cerebral palsy ensued. By 1993 Tracy could laugh, smile, and cry, and she could recognize her parents and her siblings. But she could not understand her own name or even simple words like "yes" and "no." She could not swallow well and would so often vomit her parents kept …

Physician-Assisted Suicide: The Problems Presented By The Compelling, Heartwrenching Case, Yale Kamisar

Articles

Now that the U.S. Supreme Court has upheld New York and Washington state laws prohibiting the aiding of another to commit suicide,2 the spotlight will shift to the state courts, the state legislatures and state referenda. And once again proponents of physician-assisted suicide (PAS) will point to a heartwrenching case, perhaps the relatively rare case where a dying person is experiencing unavoidable pain (i.e., pain that not even the most skilled palliative care experts are able to mitigate), and ask: What would you want done to you if you were in this person's shoes?

The Future Of Physician-Assisted Suicide, Yale Kamisar

Articles

I believe that when the Supreme Court handed down its decisions in 1997 in Washington v. Glucksberg and Vacca v. Quill, proponents of physician-assisted suicide (PAS) suffered a much greater setback than many of them are able or willing to admit.

On The Meaning And Impact Of The Physician-Assisted Suicide Cases. (Symposium: Physician-Assisted Suicide: Facing Death After Glucksberg And Quill), Yale Kamisar

Articles

I read every newspaper article I could find on the meaning and impact of the U.S. Supreme Court's June 1997 decisions in Washington v. Glucksberg' and Vacco v. Quill.2 I came away with the impression that some proponents of physician-assisted suicide (PAS) were unable or unwilling publicly to recognize the magnitude of the setback they suffered when the Court handed down its rulings in the PAS cases.

"Countering Stereotypes." Review Of Medical Malpractice And The American Jury: Confronting The Myths About Jury Incompetence, Deep Pockets, And Outrageous Damage Awards, By N. Vidmar, Samuel R. Gross

Reviews

The story of The Medical Malpractice Trial has a place in popular American legal culture, somewhere on the shelf with Killers Who Got Off on Technicalities. The plot is simple and tragic. The protagonist is the Doctor, a good man with a flaw: He tries too hard. In the process, he makes an innocent mistake or believes he can prevent the unpreventable. In any event, he fails and the Patient dies or is permanently injured. For this unintentional error the Doctor is crucified, by the vengeful anger of the Patient or her survivors, the avarice of the plaintiffs' lawyer, the …

Making Sausage: The Ninth Circuit's Opinion, Carl E. Schneider

Articles

As I write, the Supreme Court has just agreed to hear Compassion in Dying v. Washington and Quill v. Vacco, the two cases in which United States circuit courts of appeals held that a state may not constitutionally prohibit physicians from helping a terminally ill person who wishes to commit suicide to do so. These cases have already received lavish comment and criticism, and no doubt the Supreme Court's opinion will garner even more. Reasonably enough, most of this analysis addresses the merits of physician-assisted suicide as social policy. I, here, want to talk about how setting bioethical policy …

Physician Assisted Suicide: A Bad Idea, Yale Kamisar

Articles

It would be hard to deny that there is a great deal of support in this country - and ever-growing support - for legalizing physician-assisted suicide (PAS). Why is this so? I believe there are a considerable number of reasons. I shall discuss five common reasons - and explain why I do not find any of them convincing.

It Started With Quinlan: The Ever Expanding 'Right To Die', Yale Kamisar

Articles

Few rallying cries sound more straightforward than the "right to die"-but few are more fuzzy or more misunderstood. This becomes all too evident when comparing the right-to-die decision handed down by the U.S. Ninth Circuit Court of Appeals earlier this month and the New Jersey Supreme Court's decision in the Karen Ann Quinlan case twenty years ago. At different times, the "right to die" has embraced significantly different rights. On March 6, in Compassion in Dying v. Washington State, the Ninth Circuit held that because a Washington state statute prohibiting assisted suicide prevents physicians from providing assistance to competent, terminally …

The Reasons So Many People Support Physician-Assisted Suicide - And Why These Reasons Are Not Convincing, Yale Kamisar

Articles

It would be hard to deny that there is a great deal of support in this country-and ever-growing support-for legalizing physician-assisted suicide (PAS). Why is this so? I believe there are a considerable number of reasons. In this article, I shall discuss five common reasons and explain why I do not find any of them convincing.

The 'Right To Die': On Drawing (And Erasing) Lines, Yale Kamisar

Articles

Until this year, no state or federal appellate court had ever held that there was a right to assisted suicide no matter how narrow the circumstances or stringent the conditions. In 1996, however, within the span of a single month, two federal courts of appeals so held; in an 8-3 majority of the Ninth Circuit (sitting en banc) in Compassion in Dying v. Washington and a three-judge panel of the Second Circuit in Quill v. Vacco. What heartened proponents of a right to physician-assisted suicide even more, and pleased those resistant to the idea even less, was that the two …

Physician Assisted Suicide: The Last Bridge To Active Voluntary Euthanasia, Yale Kamisar

Book Chapters

SOME 30 YEARS AGO an eminent constitutional law scholar, Charles L. Black, Jr, spoke of 'toiling uphill against that heaviest of all argumental weights- the weight of a slogan.' I am reminded of that observation when I confront the slogan the 'right to die.' Few rallying cries or slogans are more appealing and seductive than the 'right to die.' But few are more fuzzy, more misleading, or more misunderstood.

Against Assisted Suicide - Even A Very Limited Form (Symposium: Assisted Suicide, Health Care And Medical Treatment Choices), Yale Kamisar

Articles

Professor Robert Sedler is a leading constitutional law professor and a well-known civil liberties lawyer. I think he is right about many things. To cite but one example, I think he was right when he led the ACLU's successful legal attack on certain University of Michigan restrictions on "hate speech."' But I cannot agree with him about physician-assisted suicide, no matter how narrowly he frames the issue.2

Bioethics With A Human Face, Carl E. Schneider

Articles

This Article and the successor article I will shortly publish grow out of one reaction I have had to years of reading bioethical and legal literature. Let me begin by putting the point in its simplest, even crudest, form: That literature too often discusses the problems of health care in so disembodied and denatured a way that the patients and physicians, the family and friends, the dread and the disease are quite abstracted from the scene. The result is a literature that critically limits itself and that crucially oversimplifies the issues it confronts. There are, of course, reasons bioethical and …

The 'Right To Die': A Catchy But Confusing Slogan, Yale Kamisar

Articles

Some 30 years ago an eminent constitutional law scholar Charles L. Black, Jr., spoke of "toiling uphill against that heaviest of all argumental weights-the weight of a slogan. I am reminded of that observation when I confront the slogan the "right to die." Few rallying cries or slogans are more appealing and seductive than the "right to die." But few are more fuzzy, more misleading, and more misunderstood.

Assisted Suicide And Euthanasia: The Cases Are In The Pipeline, Yale Kamisar

Articles

When I first wrote about this subject 36 years ago, the chance that any state would legalize assisted suicide or active voluntary euthanasia seemed minuscule. The possibility that any court would find these activities protected by the Due Process Clause seemed so remote as to be almost inconceivable. Not anymore. Before this decade ends, at least several states probably will decriminalize assisted suicide and/or active voluntary euthanasia. [Editor's note: In November, Oregon became the first state to legalize physician-assisted suicide, allowing doctors to prescribe lethal medication for competent, terminally ill adults who request it.] A distinct possibility also exists that …

Should Active Euthanasia Be Legalized? No: Preserve Traditional Restraints, Yale Kamisar

Articles

The distinction between letting people die and killing them by lethal injection is now an integral part of the medico-legal landscape. This is the compromise we have arrived at in the struggle to take a humane approach toward seriously ill patients while still preserving as many traditional restraints against killing as we possibly can. This may be neither the logician's or the philosopher's way to resolve the controversy, but it may nevertheless be a defensible pragmatic way to do so.