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Mid-Atlantic Ethics Committee Newsletter, Spring 2014

Mid-Atlantic Ethics Committee Newsletter

No abstract provided.

Throwing Dirt On Doctor Frankenstein’S Grave: Access To Experimental Treatments At The End Of Life, Michael J. Malinowski

Journal Articles

All U.S. federal research funding triggers regulations to protect human subjects known as the Common Rule, a collaborative government effort that spans seventeen federal agencies. The Department of Health and Human Services has been in the process of re-evaluating the Common Rule comprehensively after decades of application and in response to the jolting advancement of biopharmaceutical science. The Common Rule designates specific groups as “vulnerable populations”—pregnant women, fetuses, children, prisoners, and those with serious mental comprehension challenges—and imposes heightened protections of them. This article addresses a question at the cornerstone of regulations to protect human subjects as biopharmaceutical research and …

Throwing Dirt On Doctor Frankenstein’S Grave: Access To Experimental Treatments At The End Of Life, Michael J. Malinowski

UC Law Journal

U.S. federal research funding triggers regulations to protect human subjects known as the Common Rule, a collaborative government effort that spans seventeen federal agencies. The Department of Health and Human Services has been in the process of comprehensively reevaluating the Common Rule, which designates specific groups as “vulnerable populations”—pregnant women, fetuses, children, prisoners, and those with serious cognitive challenges—and imposes heightened protections of them. Given the vulnerabilities of those who confront end-of-life decisionmaking, should the regulatory standard be raised to more effectively protect the terminally ill from additional suffering and the loss of quality time with family and friends? Alternatively, …

Communicating With Patients And Families About Difficult End Of Life Decisions: A Guide For Medical Providers, Jim Demaine, Joi Murotani Dennett

Hamline Law Review

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The Nursing Home As Part Of The Polst Paradigm, Marshall B. Kapp

Hamline Law Review

abstract

The Making Of A Myth: Unreliable Data On Access To Palliative Care In Canada, Jocelyn Downie, Georgia Lloyd-Smith

Articles, Book Chapters, & Popular Press

Assisted death is now the subject of conversation in the media, in public meetings, and around kitchen tables across the country. A frequent part of many conversations about assisted death law reform is access to quality palliative care in Canada. Throughout the literature and other forms of media, the claim is made that only 16-30% of Canadians have access to palliative care (or, its derivative, 70% are without access). The “16-30%” claim has been widely accepted as a fact. But is it, in fact, true? We are driven to the conclusion that the oft-repeated claim that only 16-30% of Canadians …

Gently Into The Good Night: Toward A Compassionate Response To End-Stage Illness, George P. Smith Ii

Scholarly Articles

End-of-life decision making by health care providers must respect individual patient values. Indeed, these values must always be viewed as the baseline for developing and pursuing patient-centered palliative care for those with terminal illness. Co-ordinate with this fundamental bioethics principle is that of beneficence or, in other words, respect for conduct which benefits the dying patient by alleviating end-stage suffering — be it physical or existential. Compassion, charity, agape and/or just common sense, should be a part of setting normative standards and of legislative and judicial responses to the task of managing death. Aided by the principles of medical futility, …

A Nudge In The Right Direction With A Stick The Size Of Cms: Physician-Patient Communication At The End Of Life, Katherine B. Ledden

Saint Louis University Journal of Health Law & Policy

No abstract provided.

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 …

The Role Of Race In End-Of-Life Care, Barbara A. Noah

Journal of Health Care Law and Policy

No abstract provided.

The Role Of Race In End-Of-Life Care, Barbara A. Noah

Faculty Scholarship

This essay focuses on one important aspect of racial disparities that has received comparatively little attention in the legal literature--the existence and causes of racial differences in end-of-life decision making and in the utilization of palliative and hospice care. African Americans and other racial minorities in the United States utilize palliative care and hospice less frequently than white Americans. These minority populations also tend to resist advance care planning and instead opt to receive more life-prolonging care at the end of life, even when quality of life and prognosis are poor. After a lifetime of limited access to health care …

Palliative Care And Hospice: Opportunities To Improve Care For The Sickest Patients, Kathleen Tschantz Unroe, Diane E. Meier

Notre Dame Journal of Law, Ethics & Public Policy

The article discusses how palliative care and hospice services address the quality and cost concerns in the U.S. health care system. By focusing on symptom management, coordination among providers, and improved transitions of care, the services meet the needs of the sickest persons at lower costs. The author suggests putting in place the right leadership and resources and strengthening the workforce to successfully expand the programs.

Volunteer Prisoners Provide Hospice To Dying Inmates, Janice A. Cichowlas, Yi-Ju Chen

Annals of Health Law and Life Sciences

No abstract provided.

La Caja De Pandora: Improving Access To Hospice Care Among Hispanic And African-American Patients, Kathy L. Cerminara, Alina M. Perez

Faculty Scholarship

Many patients clinging to hope in the form of potentially curative treatment could benefit from hospice services, but, for the most part, it is not until the patient accepts the finality of his or her condition that the physical, psychological and social benefits of hospice care become accessible to the patient and his or her family. Under current Medicare regulations and other health care payers’ policies, patients must abandon the hope of curative treatment before opting for hospice services. As a result, many terminally ill patients access the services late, sometimes a few hours before death. Scholars have proposed that …

Promoting Public Health Through Clinical Legal Education: Initiatives In South Africa, Thailand, And Ukraine, Tamar Ezer, Ludmylla Deshko, Nicola Gunn Clark, Enga Kameni, Bruce A. Lasky

Human Rights Brief

No abstract provided.

Promoting Public Health Through Clinical Legal Education: Initiatives In South Africa, Thailand, And Ukraine, Tamar Ezer

Articles

No abstract provided.

On Hastening Death Without Violating Legal And Moral Prohibitions, Norman L. Cantor

Loyola University Chicago Law Journal

No abstract provided.

From Quinlan To Cruzan To Schiavo: What Have We Learned?, William H. Colby

Loyola University Chicago Law Journal

No abstract provided.

Medicinal Marijuana And Palliative Care: Carving A Liberty Interest Out Of The Glucksberg Framework , Adam Hyatt

Fordham Urban Law Journal

In Gonzales v. Raich, the Supreme Court vacated the Ninth Circuit’s decision and held that the Controlled Substances Act was not an unconstitutional exercise of the Commerce Clause, yet never reached the substantive due process claim or the medical necessity. This Comment assesses whether there is a right to palliative care and focuses on the substantive due process claim available to the plaintiffs on remand. This Comment argues that, in view of the Court’s precedents, there is a right, subject to limitations, to use last-resort medical marijuana. In addition, the author determines that there is a fundamental right to palliative …

On Hastening Death Without Violating Legal Or Moral Prohibitions, Norman L. Cantor

Rutgers Law School (Newark) Faculty Papers

While the vast majority of fatally afflicted persons have a powerful wish to remain alive, some stricken persons may, for any of a host of reasons, desire to hasten death. Some persons are afflicted with chronic degenerative diseases that take a grievous toll. Chronic pain may be severe and intractable, anxiety about a future treatment regimen may be distressing, and helplessness may erode personal dignity and soil the image that the afflicted person wants to leave behind.

A dying patient’s interest in hastening death is often said to be in tension with a bedrock social principle that respect for sanctity …

Mid-Atlantic Ethics Committee Newsletter, Spring 2005

Mid-Atlantic Ethics Committee Newsletter

No abstract provided.

Mid-Atlantic Ethics Committee Newsletter, Summer 2004

Mid-Atlantic Ethics Committee Newsletter

No abstract provided.

Escape From New York: Analyzing The State's Relative Interests In Proscribing The Withdrawal Of Life Support And Physician-Assisted Suicide, Colin Miller

Faculty Publications

This Note argues that states cannot consistently prohibit physician assisted suicide for terminally ill patients while they continue to allow the withdrawal of life support for even non-terminal patients. All of the state interests identified by the Supreme Court in rejecting a right to assisted suicide are implicated to a higher degree by withdrawal of life support. The primary reason for this difference is that withdrawal of life support often involves incompetent patients and surrogate decision making while assisted suicide by definition requires a competent patient choosing to hasten her death.

Managing Advanced Illness: A Quality And Cost Challenge To Medicare, Medicaid, And Private Insurers, Karen Matherlee

National Health Policy Forum

This issue brief examines approaches to delivering and financing health services for persons with advanced chronic illness. It focuses on the nature and structure of the Medicare hospice benefit and its use as a model for Medicaid and other federal programs. The paper also looks at palliative-care approaches along the continuum of inpatient and post-acute services and raises cost, quality, and access issues for end-of-life care. In addition, it provides an overview of coverage through private insurance, including indemnity, point-of-service, and preferred-provider-organization products.

Curing Healthcare Providers' Failure To Administer Opioids In The Treatment Of Severe Pain, Rima J. Oken

Cardozo Law Review

No abstract provided.

The Science, Law, And Politics Of Fetal Pain Legislation, Kevin C. Walsh

Scholarly Articles

Most people prefer not to inflict gratuitous pain on other sentient beings, especially other humans. What, then, should be the legal system's reaction to the mounting evidence that in late-term abortions doctors are inflicting just such pain on fetuses who have the anatomical, physiological, and neurological capacity to experience it? The pain being inflicted is gratuitous because it can be easily avoided with no significant increases in cost or health risk by the administration of tar geted fetal pain relief. If informed that an abortion is likely to cause pain to the fetus and given a choice between a procedure …

The Legal Bounds Of Physician Conduct Hastening Death, Norman L. Cantor, George C. Thomas Iii

Buffalo Law Review

No abstract provided.

Hospice At The Crossroads: Can It Survive?, David A. Simpson

Journal of Health Care Law and Policy

No abstract provided.

A Proposal To Recognize A Legal Obligation On Physicians To Provide Adequate Medication To Alleviate Pain, Tonya Eippert

Journal of Law and Health

This note seeks to show how the current practice among medical practitioners in the United States, by treating pain retroactively after it begins, is inadequate. Administering narcotics to patients on an "as needed" basis unnecessarily prolongs pain and suffering. A more effective approach, which is advocated by the Agency for Health Care Policy & Research (AHCPR), is to treat pain preventatively rather than retroactively. The myth that pain medication is addictive, and that physicians should therefore prescribe as little pain medication as possible, is just that, a myth. Patients are suffering pain in today's hospitals and at home unnecessarily. Given …