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Bioethics And Law In The United States: A Legal Process Perspective, Charles Baron Aug 2013

Bioethics And Law In The United States: A Legal Process Perspective, Charles Baron

Charles H. Baron

An analytical exposition of the law regarding a patient's "right to die" as it has developed in the United States over the last 30 years provides an exemplar overview of the variety of legal mechanisms that American legal institutions can and do bring to bear to deal with the challenges posed by new developments in medicine and the biosciences. Opposing "pro-life" and "pro-choice" ideological and political forces have been channeled through the federal and state legislative, judicial, and executive branches, where the various legal actors have developed legal principles that so far provide patients with a right to refuse any …


Life And Death Decision-Making: Judges V. Legislators As Sources Of Law In Bioethics, Charles Baron Aug 2013

Life And Death Decision-Making: Judges V. Legislators As Sources Of Law In Bioethics, Charles Baron

Charles H. Baron

In some situations, courts may be better sources of new law than legislatures. Some support for this proposition is provided by the performance of American courts in the development of law regarding the “right to die.” When confronted with the problems presented by mid-Twentieth Century technological advances in prolonging human life, American legislators were slow to act. It was the state common law courts, beginning with Quinlan in 1976, that took primary responsibility for gradually crafting new legal principles that excepted withdrawal of life-prolonging treatment from the application of general laws dealing with homicide and suicide. These courts, like the …


Competency And Common Law: Why And How Decision-Making Capacity Criteria Should Be Drawn From The Capacity-Determination Process, Charles Baron Aug 2013

Competency And Common Law: Why And How Decision-Making Capacity Criteria Should Be Drawn From The Capacity-Determination Process, Charles Baron

Charles H. Baron

Determining competence to request physician-assisted suicide should be no more difficult than determining competence to refuse life-prolonging treatment. In both cases, criteria and procedures should be developed out of the process of actually making capacity determinations; they should not be promulgated a priori. Because patient demeanor plays a critical role in capacity determinations, it should be made part of the record of such determinations through greater use of video- and audiotapes.


The Concept Of Person In The Law, Charles Baron Aug 2013

The Concept Of Person In The Law, Charles Baron

Charles H. Baron

The focus of the abortion debate in the United States tends to be on whether and at what stage a fetus is a person. I believe this tendency has been unfortunate and counterproductive. Instead of advancing dialogue between opposing sides, such a focus seems to have stunted it, leaving advocates in the sort of “I did not!” – “You did too!” impasse we remember from childhood. Also reminiscent of that childhood scene has been the vain attempt to break the impasse by appeal to a higher authority. Thus, the pro-choice forces hoped they had proved the pro-life forces “wrong” by …


Medical Paternalism And The Rule Of Law: A Reply To Dr. Relman, Charles Baron Aug 2013

Medical Paternalism And The Rule Of Law: A Reply To Dr. Relman, Charles Baron

Charles H. Baron

In this Article, Professor Baron challenges the position taken recently by Dr. Arnold Relman in this journal that the 1977 Saikewicz decision of the Supreme Judicial Court of Massachusetts was incorrect in calling for routine judicial resolution of decisions whether to provide life-prolonging treatment to terminally ill incompetent patients. First, Professor Baron argues that Dr. Relman's position that doctors should make such decisions is based upon an outmoded, paternalistic view of the doctor-patient relationship. Second, he points out the importance of guaranteeing to such decisions the special qualities of process which characterize decision making by courts and which are not …


On Knowing One's Chains And Decking Them With Flowers: Limits On Patient Autonomy In "The Silent World Of Doctor And Patient", Charles Baron Aug 2013

On Knowing One's Chains And Decking Them With Flowers: Limits On Patient Autonomy In "The Silent World Of Doctor And Patient", Charles Baron

Charles H. Baron

In this article Professor Baron continues the debate started by Jay Katz in his book "The Silent World of Doctor and Patient" on the necessity of exploring further patients' reasons for refusing treatment.


Assuring "Detached But Passionate Investigation And Decision": The Role Of Guardians Ad Litem In Saikewicz-Type Cases, Charles Baron Aug 2013

Assuring "Detached But Passionate Investigation And Decision": The Role Of Guardians Ad Litem In Saikewicz-Type Cases, Charles Baron

Charles H. Baron

The author focuses this Article upon the aspect of the Saikewicz decision which determines that the kind of "proxy consent" question involved in that case required for its decision "the process of detached but passionate investigation and decision that forms the ideal on which the judicial branch of government was created." This aspect of the decision has drawn much criticism from the medical community on the ground that it embroils what doctors believe to be a medical question in the adversarial processes of the court system. The author criticizes the decision from an entirely opposite perspective, arguing that the court's …


Hastening Death: The Seven Deadly Sins Of The Status Quo, Charles Baron Aug 2013

Hastening Death: The Seven Deadly Sins Of The Status Quo, Charles Baron

Charles H. Baron

The seven deadly sins of the status quo -- inhumanity, paternalism, Utilitarianism, hypocrisy, lawlessness, injustice, and the deadly risk of error and abuse -- are seven arguments against maintaining the artificial bright-line distinction between the prohibition against assisted suicide and the allowance of patients’ right to refuse life-prolonging treatment. This article calls on courts and legislatures to follow the successful example of the Oregon Death with Dignity statute.


Medical Malpractice Reform Measures And Their Effects, Robert Leflar Jun 2013

Medical Malpractice Reform Measures And Their Effects, Robert Leflar

Robert B Leflar

New rules and methods for medical injury dispute resolution have been launched in New Hampshire and New York, and demonstration projects are underway elsewhere. This article describes major medical malpractice reforms undertaken and proposed in recent years. Reforms are classified as (1) liability-limiting initiatives favoring health-care providers; (2) procedural innovations promoted as improving dispute resolution processes, such as patient compensation funds, “sorry” laws, disclosure and early offer laws, health courts, and safe harbor laws; and (3) major conceptual reforms to move liability away from physicians to hospitals or administrative no-fault compensation systems. Empirical evidence about the practical effects of already-implemented …


Compliance With Advance Directives: Wrongful Living And Tort Law Incentives, Holly Lynch, Michele Mathes, Nadia Sawicki Feb 2011

Compliance With Advance Directives: Wrongful Living And Tort Law Incentives, Holly Lynch, Michele Mathes, Nadia Sawicki

Nadia N. Sawicki

Modern ethical and legal norms generally require that deference be accorded to patients' decisions regarding treatment, including decisions to refuse life-sustaining care, even when patients no longer have the capacity to communicate those decisions to their physicians. Advance directives were developed as a means by which a patient's autonomy regarding medical care might survive such incapacity. Unfortunately, preserving patient autonomy at the end of life has been no simple task. First, it has been difficult to persuade patients to prepare for incapacity by making their wishes known. Second, even when they have done so, there is a distinct possibility that …


Blood Transfusions, Jehovah’S Witnesses, And The American Patients’ Rights Movement, Charles Baron Dec 2010

Blood Transfusions, Jehovah’S Witnesses, And The American Patients’ Rights Movement, Charles Baron

Charles H. Baron

The litigation to protect Jehovah’s Witnesses from unwanted blood transfusions, which their theology considers a violation of the biblical prohibition against drinking blood, has produced important changes in both the right to refuse treatment and in the preferred treatment methods of all patients. This article traces the evolution of the rights of competent medical patients in the United States to refuse medical treatment. It also discusses the impact this litigation has had on the medical community’s realization that blood transfusions were neither as safe nor as medically necessary as medical culture posited.


The Regulation Of Medical Malpractice In Japan, Robert Leflar Dec 2008

The Regulation Of Medical Malpractice In Japan, Robert Leflar

Robert B Leflar

How Japanese legal and social institutions handle medical errors is little known outside Japan. For almost all of the 20th century, a paternalistic paradigm prevailed. Characteristics of the legal environment affecting Japanese medicine included few attorneys handling medical cases, low litigation rates, long delays, predictable damage awards, and low-cost malpractice insurance. However, transparency principles have gained traction and public concern over medical errors has intensified. Recent legal developments include courts' adoption of a less deferential standard of informed consent; increases in the numbers of malpractice claims and of practicing attorneys; more efficient claims handling by specialist judges and speedier trials; …


Children’S Rights To Representation: A Comparison Between Sweden And England, Titti Mattsson, Eva Ryrstedt Dec 2007

Children’S Rights To Representation: A Comparison Between Sweden And England, Titti Mattsson, Eva Ryrstedt

Titti Mattsson

In both England and in Sweden, the approach to a child's right to representation differs between public law cases and private law cases regarding legal custody/parental responsibility, residence or contact. This article discusses the basis for this distinction, and how far it accords with the best interests of the child.


Life And Death Decision-Making: Judges V. Legislators As Sources Of Law In Bioethics, Charles Baron Dec 2003

Life And Death Decision-Making: Judges V. Legislators As Sources Of Law In Bioethics, Charles Baron

Charles H. Baron

In some situations, courts may be better sources of new law than legislatures. Some support for this proposition is provided by the performance of American courts in the development of law regarding the “right to die.” When confronted with the problems presented by mid-Twentieth Century technological advances in prolonging human life, American legislators were slow to act. It was the state common law courts, beginning with Quinlan in 1976, that took primary responsibility for gradually crafting new legal principles that excepted withdrawal of life-prolonging treatment from the application of general laws dealing with homicide and suicide. These courts, like the …


Competency And Common Law: Why And How Decision-Making Capacity Criteria Should Be Drawn From The Capacity-Determination Process, Charles Baron May 2000

Competency And Common Law: Why And How Decision-Making Capacity Criteria Should Be Drawn From The Capacity-Determination Process, Charles Baron

Charles H. Baron

Determining competence to request physician-assisted suicide should be no more difficult than determining competence to refuse life-prolonging treatment. In both cases, criteria and procedures should be developed out of the process of actually making capacity determinations; they should not be promulgated a priori. Because patient demeanor plays a critical role in capacity determinations, it should be made part of the record of such determinations through greater use of video- and audiotapes.


On Knowing One's Chains And Decking Them With Flowers: Limits On Patient Autonomy In 'The Silent World Of Doctor And Patient', Charles Baron Dec 1986

On Knowing One's Chains And Decking Them With Flowers: Limits On Patient Autonomy In 'The Silent World Of Doctor And Patient', Charles Baron

Charles H. Baron

In this article Professor Baron continues the debate started by Jay Katz in his book "The Silent World of Doctor and Patient" on the necessity of exploring further patients' reasons for refusing treatment.


The Concept Of Person In The Law, Charles Baron Dec 1982

The Concept Of Person In The Law, Charles Baron

Charles H. Baron

The focus of the abortion debate in the United States tends to be on whether and at what stage a fetus is a person. I believe this tendency has been unfortunate and counterproductive. Instead of advancing dialogue between opposing sides, such a focus seems to have stunted it, leaving advocates in the sort of “I did not!” – “You did too!” impasse we remember from childhood. Also reminiscent of that childhood scene has been the vain attempt to break the impasse by appeal to a higher authority. Thus, the pro-choice forces hoped they had proved the pro-life forces “wrong” by …


Licensure Of Health Care Professionals: The Consumer's Case For Abolition, Charles Baron Dec 1982

Licensure Of Health Care Professionals: The Consumer's Case For Abolition, Charles Baron

Charles H. Baron

While state medical licensure laws ostensibly are intended to promote worthwhile goals, such as the maintenance of high standards in health care delivery, this Article argues that these laws in practice are detrimental to consumers. The Article takes the position that licensure contributes to high medical care costs and stifles competition, innovation and consumer autonomy. It concludes that delicensure would expand the range of health services available to consumers and reduce patient dependency, and that these developments would tend to make medical practice more satisfying to consumers and providers of health care services.


Medical Paternalism And The Rule Of Law: A Reply To Dr. Relman, Charles Baron Dec 1978

Medical Paternalism And The Rule Of Law: A Reply To Dr. Relman, Charles Baron

Charles H. Baron

In this Article, Professor Baron challenges the position taken recently by Dr. Arnold Relman in this journal that the 1977 Saikewicz decision of the Supreme Judicial Court of Massachusetts was incorrect in calling for routine judicial resolution of decisions whether to provide life-prolonging treatment to terminally ill incompetent patients. First, Professor Baron argues that Dr. Relman's position that doctors should make such decisions is based upon an outmoded, paternalistic view of the doctor-patient relationship. Second, he points out the importance of guaranteeing to such decisions the special qualities of process which characterize decision making by courts and which are not …


Assuring "Detached But Passionate Investigation And Decision": The Role Of Guardians Ad Litem In Saikewicz-Type Cases, Charles Baron Dec 1977

Assuring "Detached But Passionate Investigation And Decision": The Role Of Guardians Ad Litem In Saikewicz-Type Cases, Charles Baron

Charles H. Baron

The author focuses this Article upon the aspect of the Saikewicz decision which determines that the kind of "proxy consent" question involved in that case required for its decision "the process of detached but passionate investigation and decision that forms the ideal on which the judicial branch of government was created." This aspect of the decision has drawn much criticism from the medical community on the ground that it embroils what doctors believe to be a medical question in the adversarial processes of the court system. The author criticizes the decision from an entirely opposite perspective, arguing that the court's …