Health Law and Policy Commons^™

Patients, Agents, And Informed Consent, Joram Graf Haber

Journal of Law and Health

In Part II of this article, I develop the "patient" / agent distinction from the vantage point of humanistic ethics. This is the view that the knowledge of man is the basis for establishing norms and values. In Part III, I argue that the "patient" / agent distinction correlates the the Kantian notions of heteronomy / autonomy, and disrespect for autonomy / respect for autonomy. In Part IV, I show that the "patient" / agent distinction also correlates with the standards of disclosure the courts have adopted in deciding informed consent cases. Finally, in Part V, I show how the …

Refusal Of Lifesaving Treatment For Minors, George J. Annas

Faculty Scholarship

I feel very comfortable talking about human rights, civil rights, the role of individual privacy, autonomy, and dignity in making decisions about oneself. Yesterday's topics concerning adults and privacy, however, were much easier than today's, which deal with children. It's not difficult to argue for the right of competent adults, whether it be in Texas' or California,2 to make their own decisions. As much as we may or may not agree with their decisions, at least arguing that -competent individuals like Dax Cowart and Elizabeth Bouvia have a right to make their own decisions makes a lot of sense; the …

Potentially Hazardous Merchandise: Domestic And International Mechanisms For Consumer Protection, Eric Shuman

Vanderbilt Journal of Transnational Law

Health disorders engendered by hazardous, exported foods, pesticides, drugs, and other products recently have attracted worldwide attention. The exportation of products which have been banned or highly restricted in their country of origin or which become hazardous in the environment of the importing nation is a popular issue for opponents of a perceived monolithic transnational industrial complex, as well as for critics of certain United States corporations. A more widely shared opinion is that the United States has a moral obligation to limit foreseeable harm from the export of potentially hazardous merchandise or at least to supply product hazard information. …

The Case For Medical Licensure, George J. Annas

Faculty Scholarship

Locke et al. argue elsewhere in this issue that medical licensure should be abolished. Their reasoning is direct and seductive - but their free market cure is worse than the disease they describe. Their major premise, for example, is simply wrong: "Any governmental action that violates individual rights is improper." For this notion they cite the ultraconservative novelist Ayn Rand who talks about things that are "right" for humans to do. But there are two confusions: (I) rights do not exist in a vacuum; in an interdependent society the rights of individuals must sometimes be balanced against the rights of …

How To Make The Massachusetts Patients' Bill Of Rights Work, George J. Annas

Faculty Scholarship

The movement for enhanced patients' rights is based on two premises: (I) citizens possess certain rights that are not automatically forfeited by entering into a relationship with a physician or health care facility; and (2) most physicians and health care facilities fail to recognize these rights, fall to provide for their protection or assertion, and limit their exercise without recourse.

The primary argument against patients' rights is that patients have "needs" and defining these needs in terms of rights leads to the creation of an unhealthy adversary relationship.' It is not, however, the creation of rights, but the disregard of …

Where Are The Health Lawyers When We Need Them, George J. Annas

Faculty Scholarship

A momentous event in the field of health law occurred in April of 1978: the first national meeting of teachers of health law was held at Boston University. Of sixty individuals invited, almost all of whom teach health law as a full-time profession in various graduate schools, forty-five participated in the two-day workshop. While that response alone may have revealed the answer, the first topic on the agenda was: "Is health law a discipline?"

Judges At The Bedside: The Case Of Joseph Saikewicz, George J. Annas

Faculty Scholarship

In what may prove to be the most controversial medicolegal decision of the year, the Massachusetts Supreme Judicial Court has ruled that, in certain cases, courts are the proper forum in which life-sustaining medical decisions should be made.1 The controversy goes deep. It involves questions of who should make life-prolonging decisions, in what forum, and on what criteria. Until the last few years, these questions arose almost exclusively in the context of Jehovah's Witnesses cases - cases in which life-saving blood transfusions were being refused for religious reasons. But with society's increasing consciousness about the way people die in hospitals, …

When You Enter The Hospital Check Your Rights At The Door, George J. Annas

Faculty Scholarship

Civil libertarians have little difficulty appreciating the plight of prisoners or mental patients. But tell the average civil libertarian that there are significant and unnecessary restrictions on the individual rights and liberties of patients in general hospitals, and you are likely to encounter a blank stare. There are a number of reasons for this lack of attention to hospitals. One is the general misconception that the problems are minor, or that certain temporary restrictions on individuals are essential if hospitals are to treat sick people properly. An unconscious desire not to perceive ourselves as being at risk may be another …

Recent Developments, Mark J. Mathiesen

Vanderbilt Law Review

Under the existing statute Congress has attempted by legislation to encourage the development of HMOs as a viable alternative for the health-care consumer. As is often the casein the political world of Congress, the fanfare accompanying a legislative response has obscured the deficiencies of the answer. This act with its limited appropriations, restricted preemption language,and failure to support profit-making HMOs constitutes an experimental approach to the HMO concept, and therefore, only illusionary support for its development.

Malicious Prosecution Suits As Counterbalance To Medical Malpractice Suits, Allen P. Adler

Cleveland State Law Review

A few years ago medical malpractice suits were something of a rarity in the United States. They now appear to be a major national problem. The magnitude of this ever increasing problem can be illustrated by the fact that a Senate subcommittee, chaired by Sen. Abraham Ribicoff, has investigated the increase in malpractice litigation and that President Nixon has ordered the establishment of a Commission on Medical Malpractice, under the Department of Health, Education and Welfare, to research the problem and report a possible solution by March 1, 1972.

Hospital Liability: Implications Of Recent Physician's Assistant Statutes, Daniel W. Coyne

Cleveland State Law Review

New methods must be devised to increase the efficient use of the available supply of physicians. "Among the innovations being tried with physicians is the development of new disciplines involving assistants to physicians." Increasing utilization of returning medics from the armed forces is being undertaken to help relieve the civilian manpower shortage. The legal implications of these developments range from problems of licensure to considerations of vicarious liability for an assistant's negligence (malpractice) or for the negligence of the assistant's supervising physician. It is with a species of this latter problem that this paper will be concerned. But one ought …

Contributory Negligence In Medical Malpractice, Diane Shelby

Cleveland State Law Review

The best and most complete defense to a charge of malpractice is the allegation and proof of the absence of negligence. It is also the most often used defense. Of the less popular defenses, contributory negligence on the part of the patient is probably the least attractive and the most difficult to maintain, even though it has been held to be a complete bar to recovery in several cases difficult to categorize.

Medical Remedies And Human Rights: Why Civil Rights Lawyers Must Become Involved In Medical Decision-Making, George J. Annas

Faculty Scholarship

As recently as the turn of the century a random patient meeting a random physician had less than a 50:50 chance of benefiting from the encounter. Physicians were just beginning to emerge from the era when they were essentially tradesmen, often with little more to offer their patients than comfort and company during illness and death. The principal causes of mortality were the infectious diseases against which the medical community stood impotent. There were few medical schools, few diagnostic tests, no specific treatment of disease, and no specialization of physicians. In the words of former AMA president Dwight L. Wilbur, …

Malpractice Actions Without Expert Medical Testimony, William P. Gibbons

Cleveland State Law Review

Fear of malpractice actions against them is causing physicians to "run scared." Some physicians now say that they feel that the threat of legal action has materially altered the practice of medicine. Defensively, some medical doctors say that they are ordering additional X-rays and lab tests, just to have them on record. Others say they are just plain afraid to try new techniques and diagnostic treatments because of the specter of a malpractice action. Innovative techniques carry additional risks, and some doctors admit that in some risky situations they merely do what will keep them out of trouble rather than …

Impact Trauma As Legal Cause Of Cancer, Donald J. Ladanyi

Cleveland State Law Review

Consider the following hypothetical situation: A voluptuous blonde is window shopping along New York's fashionable Fifth Avenue. Her trek brings her to a corner street intersection which she begins to cross. A recklessly driven automobile careens around the corner and strikes the defenseless blonde pedestrian amidships, causing her to be hurled against a utility pole. Her breast strikes the pole and absorbs the full effect of the impact. A local hospital determines that her injuries consist of only a black and blue bruise spot on her breast. The swelling, due to the injury, subsides and the discoloration disappears within a …