Elder Law Commons^™

Happy 65th Birthday: What Now?, Peter J. Strauss

Articles & Chapters

No abstract provided.

Protecting The Right To Choose: Regulating Conscience Clauses In The Face Of Moral Obligation, Huseina Sulaimanee

Cardozo Journal of Equal Rights & Social Justice

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 …

Planning For Alzheimer's Disease With Mental Health Advance Directives, Lisa Ellen Brodoff

Faculty Articles

Mental Health Advance Directives (MHAD) have long been used for life planning in the context of debilitating mental conditions such as dementia and schizophrenia. As early detection and diagnosis of Alzheimer's disease has become increasingly more possible, Professor Brodoff argues in this Article that MHADs can be an extremely effective tool for planning for a future with Alzheimer's disease. Professor Brodoff suggests that all attorneys who assist clients with estate planning create a MHAD, particularly those clients who have been diagnosed with Alzheimer's disease and those with the disease in their families. The MHAD is designed to aid caregivers and …

Patient Neglect In Nursing Homes And Long-Term Care Facilities In New York State: The Need For New York To Implement Programs And Procedures To Combat Elder Neglect, Amanda Bassen

Cardozo Public Law, Policy & Ethics Journal

The article argues that New York State must enhance its legal framework and programs to address the prevalent issue of patient neglect in nursing homes and long-term care facilities. It emphasizes the need for stricter staffing requirements, improved training for caregivers, and more stringent penalties for neglect, drawing on successful models from other states and international efforts to raise awareness and implement effective solutions.

Vebas To The Rescue: Evaluating One Alternative For Public Sector Retiree Health Benefits, 42 J. Marshall L. Rev. 879 (2009), Susan E. Cancelosi

UIC Law Review

No abstract provided.

The Elderly And Health Care Rationing, George P. Smith Ii

Scholarly Articles

This Monograph derives from research undertaken during my appointment as a Visiting Scholar at The Poynter Center for The Study of Ethics and American Institutions, Indiana University, Bloomington in July-August, 2000. The thesis of this Monograph is that before contemporary society can confront the issue of health care rationing for the elderly, it must seek to integrate the disciplines of moral and ethical reasoning with the qualitative formulations of needs and resources. Until such a point is reached, however, the greatest danger to avoid is the perpetuation of non-decisions regarding health care treatment. Such "decisions" all too frequently result in …

To Pay Or Not To Pay: Medicare And The Preventable Adverse Event: A Rational Decision Of Dangerous Philosophical Change, Amy J. Chaho M.D.

Journal of Law and Health

The proposed Medicare reimbursement schedule intended to become effective in October 2008 represents a drastic change to the traditional policy of payment for needed services. The proposal mandates that certain preventable adverse events should not be reimbursed. This spending scheme is intended to improve quality while decreasing cost to the Medicare system. The goals of the spending scheme are laudable. Quality improvement, when used to improve the health, safety and general welfare of the intended patient beneficiary of the Medicare program, is a rational and compelling government interest that warrants coercive use of authorized spending power. This beneficial interest may …

Discretion To Follow The Law: The Collision Of Ohio's Nursing Home Bill Of Rights With Ohio's Political Subdivision Tort Liability Act, Peter Traska Elk & Elk Co., Ltd., Katherine Knouff

Journal of Law and Health

The Ohio Political Subdivision Tort Liability Act confers general immunity on political subdivisions. Therefore, government owned homes seek to avoid liability by raising the defenses provided by the Ohio Political Subdivision Tort Liability Act, despite the resident's rights under the Nursing Home Bill of Rights. The result is that residents of government owned nursing homes have inferior remedies for the tortious acts of a county home's employees. The disparate treatment meted out to residents of county owned homes opens the Political Subdivision Act to another challenge: equal protection. The law formerly recognized that government actors taking part in the marketplace …

Achieving Quality And Responding To Consumers - The Medicare Beneficiary Complaint Process: Who Should Respond?, Diane E. Hoffmann, Virginia Rowthorn

Faculty Scholarship

No abstract provided.

A Philosophy Of Privatization: Rationing Health Care Through The Medicare Modernization Act Of 2003, Eleanor Bhat Sorresso

Journal of Law and Health

The trend in coping with these rising Medicare costs has been to increase the role that private insurance plays in providing coverage for Medicare recipients. Much of this movement towards an increased "privatization" of Medicare has been born of the belief that the private sector of health care insurance coverage has been made more efficient by existing market forces and will provide a way to both continue providing health care to elderly Americans while containing Medicare costs through these increased efficiencies as exemplified through the managed care model. This premise will be further explored in this article. First, this article …

The Vesting, Modification, And Financing Of Public Retiree Health Benefits In Light Of New Accounting Rules, 41 J. Marshall L. Rev. 1147 (2008), John Sanchez

UIC Law Review

No abstract provided.

Electroconvulsive Therapy Baby Boomers May Be In For The Shock Of Their Lives, Helia Garrido Hull

Faculty Scholarship

No abstract provided.

Designating Health Care Decisionmakers For Patients Without Advance Directives: A Psychological Critique, Nina A. Kohn, Jeremy A. Blumenthal

Georgia Law Review

States' default surrogate statutes allow family or friends to make health care decisions for incapacitated patients who lack advance directives. Although such statutes are commonly justified on the grounds that they honor the wishes of incapacitated persons, the review of empirical research on surrogate decision making in this Article challenges this justification. The authors find that default surrogate statutes do a reasonable job of capturing majority preferences for health care decision making processes, but do not ensure that patients receive the treatment they would have selected for themselves if able. Rather,surrogates appointed under default surrogate statutes can be expected to …

Health Care Law, Sean P. Byrne, Paul Walkinshaw

University of Richmond Law Review

Arguably, no other field of law in Virginia matches the complexity, magnitude, and universality of health care. It therefore comes as little surprise that Virginia's legislative and judicial branches of government devoted substantial attention to health care law issues in 2006 and 2007. Between April 2006 and April 2007 the time period covered by this article the Supreme Court of Virginia decided a large number of cases directly affecting health care law in the Commonwealth. The 2007 legislative session also addressed a host of health care issues and those with the most impact are summarized herein. These judicial and legislative …

A Complete Property Right Amendment, John H. Ryskamp

ExpressO

The trend of the eminent domain reform and "Kelo plus" initiatives is toward a comprehensive Constitutional property right incorporating the elements of level of review, nature of government action, and extent of compensation. This article contains a draft amendment which reflects these concerns.

Disability Discrimination In Long-Term Care: Using The Fair Housing Act To Prevent Illegal Screening In Admissions To Nursing Homes And Assisted Living Facilities, Eric M. Carlson

ExpressO

Nursing homes and assisted living facilities routinely require applicants to disclose an extensive amount of medical information. Not infrequently, these long-term care facilities use the information to deny admission to those applicants with relatively greater care needs. These denials constitute illegal discrimination under the Americans with Disabilities Act and the Rehabilitation Act, but generally consumers are unaware of these protections or find litigation too expensive and time-consuming under their generally difficult circumstances.

These illegal denials of service could be limited by active enforcement of the Fair Housing Act’s no-inquiry regulation, which prohibits a housing provider from inquiring into an applicant’s …

The Convicted Felon As A Guardian: Considering The Alternatives Of Potential Guardians With Less-Than-Perfect Records, Mike Jorgensen

ExpressO

Courts require discretion in appointing guardians. Oftentimes, the legislature prevents the courts from exercising discretion when statutes are enacted that prohibit felons from serving as guardians under any circumstances. Yet, the need for guardians is increasing and will continue to do so due to the exponential growth in the aging elder population.

At the same time, however, the pool of potential guardians is shrinking in size. Additionally, the same reducing pool of eligible guardians is being attenuated further by having a disproportionate amount of felonies.

The groups most impacted by these trends are the indigent and the minorities. The indigent …

Protecting Rights Or Waiving Them? Why 'Negotiated Risk' Should Be Removed From Assisted Living Law, Eric M. Carlson

ExpressO

Assisted living facilities claim that negotiated risk agreements give residents the freedom to act against facility advice. On the contrary, negotiated risk was proposed originally to waive a facility’s liability for inadequate care, and liability waiver remains a significant component of negotiated risk.

This Article offers the first detailed legal analysis of state negotiated risk laws. Due to negotiated risk’s dueling definitions – based either on the against-facility-advice scenario or the inadequate care scenario – state law is marked by ambiguity and inconsistency. Currently, fifteen states address negotiated risk in law, and an additional state has developed a standardized negotiated …

Bond Repudiation, Tax Codes, The Appropriations Process And Restitution Post-Eminent Domain Reform, John H. Ryskamp

ExpressO

This brief comment suggests where the anti-eminent domain movement might be heading next.

Fair Housing Is Good Medicine: Applying The Fair Housing Act's No-Inquiry Regulation When Housing And Health Care Are Provided Together, Eric M. Carlson

ExpressO

The Fair Housing Act (FHA) protects individuals with disabilities from discrimination in the housing or rental markets. The FHA’s no-inquiry regulation prohibits a landlord from inquiring into an applicant’s health condition.

Although the FHA routinely has been applied to long-term care facilities – usually to protect a group home or similar facility from unfair zoning practices – the no-inquiry regulation has not been utilized to challenge the admissions practices of assisted living facilities, nursing facilities, and other long-term care facilities. Indeed, at first glance, a no-inquiry rule seems a poor fit for a facility that provides health care along with …

The Great Vanishing Benefit, Employer Provided Retiree Medical Benefits: The Problem And Possible Solutions, 39 J. Marshall L. Rev. 785 (2006), Larry Grudzien

UIC Law Review

No abstract provided.

Planning For End-Of-Life Health Care Decisions--What National Survey Results Reveal, Linda S. Whitton

Law Faculty Publications

No abstract provided.

Blame Canada (And The Rest Of The World): The Twenty-Year War On Imported Prescription Drugs, Daniel L. Pollock

ExpressO

Rising budget deficits and sticker shock over the new Medicare drug benefit have put the issue of prescription drug costs back into the spotlight. The growth in the cost of prescription drugs continues to represent a staggering burden for taxpayer-funded health care programs, even while costs of non-drug health care services have slowed or even decreased. Among the many proposals for cutting prescription drug costs, drug importation is unique. Although bipartisan support for drug importation has existed in Congress for over five years, the federal government continues to maintain that a system of safe and effective drug importation is impossible. …

Breaking The Bank: Revisiting Central Bank Of Denver After Enron And Sarbanes-Oxley, Celia Taylor

ExpressO

No abstract provided.

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 …

Make Room For Dying: End Of Life Care In Nursing Homes, Sandra H. Johnson

All Faculty Scholarship

The cornerstone of contemporary nursing home care is a commitment to patient rehabilitation. Improved care is an important and worthwhile goal, but it is a goal that has yet to make room for the dying. A significant proportion of older people will spend their final days in a nursing home. This article calls for a culture shift in nursing home care to promote improved care for not only those who can be rehabilitated but also those who are dying.

This article begins by addressing challenges to achieving this culture that are particular to the nursing home context. It then explains …

On Kamisar, Killing, And The Future Of Physician-Assisted Death, Norman L. Cantor

Rutgers Law School (Newark) Faculty Papers

In a famous 1958 article, Yale Kamisar brilliantly examined the hazards of abuse and of slippery slope extensions that subsequently, for 46 years, served to thwart legalization of physician-assisted death (PAD). This paper shows that during the same period law and culture have effectively accepted a variety of ways for stricken people to hasten death, with physicians involved in diverse roles. Those ways include rejection of nutrition and hydration, terminal sedation, administration of risky analgesics, and withholding or withdrawal of medical life support.

If these existing lawful modes of hastening death were widely acknowledged, the pressure to legalize voluntary active …

The Relation Between Autonomy-Based Rights And Profoundly Disabled Persons, Norman L. Cantor

Rutgers Law School (Newark) Faculty Papers

“The Relation Between Autonomy-based Rights and Profoundly Mentally Disabled Persons” Competent persons have fundamental rights to decide about abortion, methods of contraception, and rejection of life-sustaining medical treatment. Profoundly disabled persons are so cognitively impaired that they cannot make their own serious medical decisions. Yet some courts suggest that the mentally impaired are entitled to “the same right” to choice regarding critical medical decisions as competent persons. This article discusses the puzzling question of how to relate autonomy-based rights to never-competent persons. It argues that while profoundly disabled persons cannot be entitled to make their own medical decisions, they have …

The Bane Of Surrogate Decision Making: Defining The Best Interests Of Never-Competent Persons, Norman L. Cantor

Rutgers Law School (Newark) Faculty Papers

The medical fate of never-competent persons cannot be resolved according to the approach governing previously competent persons -- surrogate focus on self-determination via advance instructions or projections of what the now-incompetent person would want in the circumstances. For never-competent medical patients, the commonly stated approach to surrogate decision making is best interests of the incapacitated ward.

This article examines and questions the conventional wisdom regarding a "best interests of the patient" standard. When a parent is the surrogate decision maker, the medical course chosen need not be the best course, so long as it is a plausible medical option and …