Medical Jurisprudence Commons^™

Consent To Psychiatric Treatment: From Insight (Into Illness) To Incite (A Riot), Sheila Wildeman

Articles, Book Chapters, & Popular Press

The aim of this chapter is to go back to the basics on consent to treatment, starting with the right to refuse and building from there. Part II addresses the leading judicial statements on the value of medical self-determination, and in light of these statements, considers what is at stake in psychiatric treatment choice. Part III explores the three core elements of valid consent to treatment -- namely that consent be voluntary, informed and capable -- with attention to variation in the law amongst provinces and territories, and some lines of analysis and critique specifically applicable to mental health care …

From Baby M To Baby M(Anji): Regulating International Surrogacy Agreements, Yehezkel Margalit

Journal of Law and Policy

In 1985, when Kim Cotton became Britain’s first commercial surrogate mother, Europe was exposed to the issue of surrogacy for the first time on a large scale. Three years later, in 1988, the famous case of Baby M drew the attention of the American public to surrogacy as well. These two cases implicated fundamental ethical and legal issues regarding domestic surrogacy and triggered a fierce debate about motherhood, child-bearing, and the relationship between procreation, science, and commerce. These two cases exemplified the debate regarding domestic surrogacy—a debate that has now been raging for decades. A new ethical and legal debate …

Does Medical Malpractice Law Improve Health Care Quality?, Michael D. Frakes, Anupam B. Jena

Faculty Scholarship

Despite the fundamental role of deterrence in justifying a system of medical malpractice law, surprisingly little evidence has been put forth to date bearing on the relationship between medical liability forces on the one hand and medical errors and health care quality on the other. In this paper, we estimate this relationship using clinically validated measures of health care treatment quality constructed using data from the 1979 to 2005 National Hospital Discharge Surveys and the 1987 to 2008 Behavioral Risk Factor Surveillance System records. Drawing upon traditional, remedy-centric tort reforms — e.g., damage caps — we estimate that the current …

Law In The Shadow Of Violence: Can Law Help To Improve Doctor-Patient Trust In China?, Benjamin L. Liebman

Faculty Scholarship

Can law help to address the lack of trust in doctor-patient relationships in China? This essay examines the role that law, on the books and in practice, has played in the rise and resolution of patient-doctor disputes and conflict in China. Law has generally played a secondary role in medical disputes: most patient claims never make it to court, and there is little evidence that negotiated outcomes are influenced by legal standards. Yet a legal framework weighted in favor of hospitals and doctors almost certainly exacerbated doctor-patient conflict in the 2000s. Patients facing legal procedures and rules that appeared to …

Avoiding Overtreatment At The End Of Life: Physician-Patient Communication And Truly Informed Consent, Barbara A. Noah, Neal R. Feigenson

Faculty Scholarship

This Article considers how best to ensure that patients have the tools to make informed choices about their care as they near death. Informed decision making can help reduce excessive end-of-life care and unnecessary suffering, and result in care that aligns with patients’ well-considered values and preferences. The many factors that contribute to dying patients receiving too much therapy and life-prolonging care include: the culture of denial of death, physicians’ professional culture and attitudes toward treatment, physicians’ fear of liability, physicians’ avoidance of discussions about prognosis, and the impact of payment incentives that encourage overutilization of medical technologies.

Under the …

Spending Medicare’S Dollars Wisely: Taking Aim At Hospitals’ Cultures Of Overtreatment, Jessica Mantel

University of Michigan Journal of Law Reform

With Medicare’s rising costs threatening the country’s fiscal health, policymakers have focused their attention on a primary cause of Medicare’s high price tag—the overtreatment of patients. Guided by professional norms that demand they do “everything possible” for their patients, physicians frequently order additional diagnostic tests, perform more procedures, utilize costly technologies, and provide more inpatient care. Much of this care, however, does not improve Medicare patients’ health, but only increases Medicare spending. Reducing the overtreatment of patients requires aligning physicians’ interests with the government’s goal of spending Medicare’s dollars wisely. Toward that end, recent Medicare payment reforms establish a range …

Book Review: Body Banking From The Bench To The Bedside, Natalie Ram

All Faculty Scholarship

How much is a kidney worth? An ounce of breast milk? Genetic material from an individual facing a Parkinson's diagnosis? In today's America, it depends on who is selling. One might think that such body products are beyond value or that their value depends on the individual characteristics of the supplier. But under existing American law and practices, what matters more is whether the seller is also the supplier of that body product, or whether the seller is another entity, such as a pharmaceutical company, hospital, or biobanker.

In Re Guardianship Of Hailu, 131 Nev. Adv. Op. 89 (Nov. 16, 2015), Adrienne Brantley

Nevada Supreme Court Summaries

The Court determined that under NRS § 451.007 (the Uniform Determination of Death Act) the District court failed to consider whether the American Association of Neurology (AAN) guidelines adequately measure all functions of the entire brain and whether the guidelines are considered accepted medical standards by states that have adopted the Act.

Between A Bed And A Hard Place: How Washington Can Keep Psychiatric Patients In Treatment And Off The Streets, Spencer Babbitt

Seattle University Law Review

On February 27, 2013, ten psychiatric patients were being involuntarily detained in hospital emergency departments located in Pierce County under Washington State’s Involuntary Treatment Act (ITA). Despite the name of the law that authorized their detainment, these individuals were not receiving any psychiatric treatment during their confinement. Nor were they there as the result of a criminal conviction. The only thing these ten detainees were guilty of was being mentally ill. Under what is now considered to have been a misinterpretation of the ITA, counties across Washington had for years been confining mentally ill patients in hospitals not certified to …

Congress Takes A Look At A No-Fault Proposal For Medical Malpractice: Some Observations, David E. Beitzel

Akron Law Review

EVEN A CURSORY GLANCE at the news media in the recent past indicates that problems in the area of medical malpractice are rising to turbulent heights. For example, newspapers are increasingly printing long and passionate letters-to-the-editor dispraising numerous circumstances and individual types, which are allegedly the cause of the problem. The primary development, which caused the initiation of this storm, is the rising premium rate for medical malpractice insurance.' The pinch on the physician's pocketbook has resulted in outcries of frustration and anger from the medical community. Objects of these attacks have included the insurance industry, the legal profession, and …

Wrongful Birth; Preconception Torts; Duty To Inform Of Genetic Risks; Becker V. Schwartz, Gail White Sweeney

Akron Law Review

Both pairs of parents sued on their own behalfs for (1) the expenses incurred in the care and treatment of the infants and for (2) the mental distress caused them by the birth of a defective child. They also sought damages on behalf of the children for (3) wrongful life. The Court of Appeals acknowledged the first claim as valid, but dismissed the second and third. It dismissed the claims for damages for emotional distress on the precedent of its 1977 decision in Howard v. Lecher and upon the difficulty of ascertaining the value of mitigated damages prescribed by Restatement …

The Buying And Selling Of Human Organs From The Living: Why Not?, Timothy M. Hartman

Akron Law Review

This article will examine the propriety of establishing a system for the sale of human organs, especially the kidney. Initially, the debilitating malady of end stage renal disease will be discussed as will the marginal "cure" of the disease via hemodialysis. Next, the superior alternative to dialysis, i.e., kidney transplantation will be discussed in two ways. First, the current procedure of using living, related donors will be examined as well as harvesting kidneys from cadaver "donors". Second, the practice of transplantation will be explored for its ramifications to society and the participants in the following areas: medicine, psychology, and the …

Wrongful Life, Turpin V. Sortini, Janet A. Laufer

Akron Law Review

In the past fifteen years, several state appellate courts have considered wrongful birth and wrongful life causes of action. While the modern trend is to allow wrongful birth causes of action, few courts have permitted wrongful life actions to be maintained. On May 3, 1982, the California Supreme Court, in Turpin v. Sortini became the first state high court to allow a wrongful life cause of action. This casenote will examine the reasoning of the Turpin court in allowing the wrongful life claim. While Turpin appears to signal a new trend in this area of tort law, there is little …

Ohio's Statute Of Limitations, Baird V. Loeffler, Amy L. O'Neil

Akron Law Review

The decision in Baird v. Loeffler is another victory for physicians and medical malpractice insurers. It will not be well accepted by plaintiff's attorneys or by others who advocate the rights of patients, especially minors, to be compensated for injuries sustained by them due to a physician's negligence. The case focuses on an amendment to the Ohio Medical Malpractice Statute which became effective July 28, 1975. The issue in Baird is the proper statutory construction that should be given to the statute where a minor's cause of action arose prior to the effective date of the statute. In effect, the …

Right To Privacy; Removal Of Life-Support Systems; Leach V. Akron General Medical Center, Stephanie Zembar

Akron Law Review

The decision in Leach v. Akron General Medical Center, marked Summit County's acceptance of the trend allowing the removal of life support systems from an incompetent terminally ill patient. Technological advancements have enabled the medical profession to maintain a person indefinitely in a chronic vegetative state. These advancements have blurred traditional definitions of death and have raised legal, medical and ethical questions to be resolved within our court system. The Leach case was one of first impression in Ohio, and the decision should aid in establishing a framework from which members of the legal and medical professions, as well …

The Unconstitutionality Of Ohio's Medical Malpractice Statute Of Limitations: Minors And Equal Protection, Eric A. Brandt

Akron Law Review

As with all laws, statutes of limitations must apply equally to all persons unless reasonable grounds permit the legislating body to make distinctions between classes of persons affected by the law. Laws that operate unequally, unfairly and unreasonably when applied to the public are unconstitutional. The Ohio Supreme Court addressed was the constitutionality of an Ohio medical malpractice statute of limitations in Schwan v. Riverside Methodist Hospital.

Statute Of Limitations: Discovery Rule For Malpractice, Linda C. Ashar

Akron Law Review

IN OLIVER V. KAISER COMMUNITY HEALTH FOUNDATION the Ohio Supreme Court adopted the discovery standard for medical malpractice actions, which are subject to Ohio's one-year statute of limitations. In Oliver the court held that a medical malpractice cause of action "accrues and the statute of limitations commences to run when the patient discovers, or in the exercise of reasonable care and diligence should have discovered, the resulting injury." Shortly after Oliver, the court applied the discovery rule to legal malpractice cases in Skidmore & Hall v. Rottman. The discovery standard replaces Ohio's previously judicially adopted rule of termination of …

Prozac: Another Drug Wrongfully Attacked - What Can Be Done To Stop The Legal System From Driving Good Drugs Off The Market, While Protecting State And Federal Interests, Melinda M. Katz

Akron Law Review

This Comment will examine the U.S. Food and Drug Administration (FDA) as a regulatory agency, and the status of pharmaceutical products liability. The Comment will describe Prozac, an antidepressant drug currently caught in the products liability dilemma; its compliance with FDA regulations; and opposition to the drug since FDA approval. The Comment will then review American problems with pharmaceutical products liability, and solutions that other commentators have proposed. Finally, the Comment will propose that Congress erect barriers to filing claims against manufacturers for drugs that meet or exceed a higher level of FDA approval, like Bendectin and Prozac, through a …

The Pharmaceutical Access And Prudent Purchasing Act Of 1990: Federal Law Shifts The Duty To Warn From The Physician To The Pharmacist, Michael J. Holleran R.Ph.

Akron Law Review

This article will first discuss the legislation recently enacted as part of the budget reduction package passed by Congress in late 1990 and how that legislation will affect pharmacists' liability. Second, the article will address the applicable statutes of limitation regarding pharmacists in particular and within the general area of malpractice. Third, the applicable standard of care will be explored as it pertains to pharmacists as well as physicians. Coupled with the standard of care discussion is an overview of the various theories of liability which physicians and pharmacists currently face and how these may change under the Act. Finally, …

A Defense Of Physicians’ Gatekeeping Role: Balancing Patients’ Needs With Society’S Interests, Jessica Mantel

Pepperdine Law Review

Although scholars and policymakers increasingly accept the need to ration health care, physicians doing so at the bedside remains controversial. Underling this debate is how to characterize the duty of care physicians owe their individual patients. Ethically, physicians are under strict fiduciary obligations that require them to give primacy to individual patients' best interests. However, new health care delivery models that hold providers financially accountable for health care costs assign to physicians a gatekeeping role, with physicians obliged to balance individual patients' needs with the competing societal goal of controlling costs. This Article explains that the choice between the traditional …

3-D Bioprinting: Not Allowed Or Nota Allowed?, Robert Jacobson

Chicago-Kent Law Review

In 1984, Congress passed the National Organ Transplantation Act (NOTA) to improve the supply of vital human organs. A key provision of NOTA was the prohibition of acquiring, receiving, or otherwise transferring human organs. In effect, this provision bans the purchase of human organs. However, due to recent breakthroughs in 3-D bioprinting technology, scientists are on the verge of being able to create lab-grown organs suitable for transplantation. This Note will examine the applicability of NOTA to 3-D bioprinting technology and recommend amendments to NOTA that would clarify the legality of 3-D bioprinting.

Don't Call Me Crazy: A Survey Of America's Mental Health System, Justin L. Joffe

Chicago-Kent Law Review

Unfortunately, the typical exposure to mental illness for most Americans comes via tragic mass shootings or highly publicized celebrity mental breakdowns. However, the vast majority of mentally ill individuals are not violent murderers or hyper-tweeting celebrities. Rather, they are the ordinary, everyday people that make up the tens of millions of American adults suffering from some form of mental illness. The American mental health system has a lamentable history. The initial policy of locking up mentally ill individuals in jails transitioned to a system of confinement in asylums that quickly became notorious for their poor living conditions and treatment. The …

Estelle V. Gamble In A Post-Affordable Care Act World, Hallie E. Mitnick

Cardozo Public Law, Policy & Ethics Journal

No abstract provided.

Dangerous Diagnoses, Risky Assumptions, And The Failed Experiment Of "Sexually Violent Predator" Commitment, Deirdre M. Smith

Faculty Publications

In its 1997 opinion, Kansas v. Hendricks, the U.S. Supreme Court upheld a law that reflected a new model of civil commitment. The targets of this new commitment law were dubbed “Sexually Violent Predators” (SVPs), and the Court upheld indefinite detention of these individuals on the assumption that there is a psychiatrically distinct class of individuals who, unlike typical recidivists, have a mental condition that impairs their ability to refrain from violent sexual behavior. And, more specifically, the Court assumed that the justice system could reliably identify the true “predators,” those for whom this unusual and extraordinary deprivation of liberty …

Is Meaningful Peer Review Headed Back To Florida?, Brendan A. Sorg

Akron Law Review

This comment lays the foundation to evaluate the sustainability of Amendment 7 post-PSQIA in Part II by first examining medical peer review, its origin, its evolution and why peer review remains important to patient safety. Although many physicians dislike peer review, Congress has acknowledged its importance by making peer review mandatory and by providing the statutory protections to ensure peer review remains meaningful.7 States have followed suit, passing their own laws that provide for the protection of peer review materials. Part II also addresses how Amendment 7 reversed Florida’s historical approach providing broad peer review protection and how this erosion …

Montana Expands Psychotherapists Privilege, Matching Federal Rules, Cynthia Ford

Faculty Journal Articles & Other Writings

No abstract provided.

The Scramble To Promote Egg Donation Through A More Protective Regulatory Regime, Jacob Radecki

Chicago-Kent Law Review

Egg “donation” is a burgeoning industry in the United States. Fertility clinics capitalize on financially needy college students by advertising substantial financial benefits; particularly gifted women may receive thousands of dollars for selling their eggs. Rosy advertisements portray a well-paying procedure that also helps bring a child to a loving parent. Yet these descriptions mask significant potential harms. With respect to known problems, hormone regimens may cause ovarian hyper-stimulation syndrome, which in the most severe cases can lead to infertility. In terms of unknown risks, anecdotal evidence suggests that the long-term side effects of egg extraction may include cancer. The …

Keeping The Gates Open For Human Embryonic Stem Cell Research, Ren-How Harn

Cardozo Public Law, Policy & Ethics Journal

Human embryonic stem cell research represents an area of scientific progress that promises to deliver on the wonders mankind has thus far only seen in science fiction movies. However, ethical and legal concerns threaten to stifle research in an area often regarded as the holy grail of regenerative medicine. This Note analyzes the question in patent law of whether human embryonic stem cells constitute patentable subject matter under 35 U.S.C. §101 from a legal and policy perspective after the 2013 Supreme Court decision in Association for Molecular Pathology v. Myriad. The issue has generated recent interest and debate with …

Piercing The Veil: The Limits Of Brain Death As A Legal Fiction, Seema K. Shah

University of Michigan Journal of Law Reform

Brain death is different from the traditional, biological conception of death. Although there is no possibility of a meaningful recovery, considerable scientific evidence shows that neurological and other functions persist in patients accurately diagnosed as brain dead. Elsewhere with others, I have argued that brain death should be understood as an unacknowledged status legal fiction. A legal fiction arises when the law treats something as true, though it is known to be false or not known to be true, for a particular legal purpose (like the fiction that corporations are persons). Moving towards greater transparency, it is legally and ethically …

Managing The Multiple Layers Of Physician Oversight, Rick D. Barton

Center for Health Law Policy and Bioethics

No abstract provided.