Blog RSS Blog.

Author Archive: Thaddeus Mason Pope, JD, PhD

About Thaddeus Mason Pope, JD, PhD

10/18/2018

Compassion & Choices Strategic Plan

Compassion & Choices has released a strategic plan for the next five years. Vision A society that affirms life and accepts the inevitability of death, embraces expanded options for compassionate dying, and empowers everyone to choose end...

Full Article

This entry was posted in Health Care and tagged . Posted by Thaddeus Mason Pope, JD, PhD. Bookmark the permalink.

10/17/2018

Unilateral DNR in 2018 (ASBH Frriday)

Join me at the Hospice and Palliative Medicine ASBH affinity group on Friday at 12:45 PM.

In light of legislation in several states, the concept of unilateral DNR in 2018 seems to be changing. New specifications regarding DNR orders are in place in Kansas, in legislation named “Simon’s Law” which applies to pediatric patients (Missouri will almost certainly have a form of Simon’s Law considered next year) and Texas in the form of SB11 which went into effect April 1. Both bills have been characterized by their supporters as patient protection legislation.

Discussion will be encouraged from participants, those who are directly affected in these states and then toward potential issues arising from statutory specifications regarding end of life care.

It would appear that, under these laws, decisions about resuscitation status and the use of life prolonging measures cannot be made without the assent/ permission of the patient or surrogate. 

Does this rob the clinician of her prerogative of employing clinical judgment?

Understanding that there are caveats in each bill and various underlying inciting events, the result appears to be that CPR, instead of being a medical procedure with indications and contraindications, is being seen as a “right” for patients. 

But isn’t it the clinician who is called, trained, licensed, and certified to discern when to employ this (and all) medical procedures?

Ethically, the principles of autonomy, beneficence, justice and non- maleficence seem to be at work. So, too, however is the necessity to explore parental/patient/family stories (narrative) and evaluate what might lie behind such demands. Relational meaning and security may also be at play feminist/care ethics). 
So, how do ethical frameworks help or hinder in these situations?
Should we entertain these demands as simply Advance Care Planning?
What about the potential erosion of trust (or presumption of distrust) which seems to be operant here?
Will potentially non-beneficial treatment be demanded? Can physicians ‘escape’ via conscientious objection clauses or recourse?
How can we [collectively] best pursue an acceptable quality of life for the patient, without harming him/her?

After a few clarifying slides and comments from Drs Richard Butin, Brian Carter and Kelstan Ellis, audience members will be asked for experiences and opinions.



Full Article

This entry was posted in Health Care and tagged . Posted by Thaddeus Mason Pope, JD, PhD. Bookmark the permalink.

10/16/2018

Payton Summons Texas Brain Death Conflict Continues

The Tarrant County, Texas District Court may be establishing dangerous precedent concerning the resolution of conflicts over the determination of death by neurological criteria. On Sept. 25, 2018, nine-year-old Payton Summons was determined de...

Full Article

This entry was posted in Health Care and tagged . Posted by Thaddeus Mason Pope, JD, PhD. Bookmark the permalink.

10/16/2018

Lawrence J. Schneiderman (1932 – 2018)

I just learned that Larry Schneiderman died this summer. He was one of the most prolific and influential writers on medical futility. His articles and books on the issue have had a significant influence on me - from my first article on the topic in 20...

Full Article

This entry was posted in Health Care and tagged . Posted by Thaddeus Mason Pope, JD, PhD. Bookmark the permalink.

10/15/2018

American Academy of Family Physicians Drops Opposition to Medical Aid in Dying

The American Academy of Family Physicians is the national association of family doctors. It is one of the largest national medical organizations, with over 131,000 members.

At its October 2018 House of Delegates meeting, the AAFP approved a substitute resolution offered by the Reference Committee on Health of the Public and Science to adopt a position of "engaged neutrality" toward medical aid in dying as a personal end-of-life decision in the context of the physician-patient relationship.

The AAFP joins a list of other professional associations have dropped their opposition to medical aid in dying and adopted a neutral position: the American Academy of Hospice and Palliative Medicine, Washington Academy of Family Physicians, American Pharmacists Association, Oncology Nursing Association, California Medical Association, California Hospice and Palliative Care Association, Colorado Medical Society, Maine Medical Association, Maryland State Medical Society, Massachusetts Medical Society, Medical Society of the District of Columbia, Minnesota Medical Association, Missouri Hospice & Palliative Care Association, Nevada State Medical Association, Oregon Medical Association, Vermont Medical Society, Hospice and Palliative Care Council of Vermont, Washington Academy of Family Physicians, and Washington State Psychological Association.

In addition, medical groups increasingly endorse medical aid in dying, including: the American College of Legal Medicine, American Medical Student Association, American Medical Women’s Association, American Nurses Association of California, American Public Health Association, GLMA: Healthcare Professionals Advancing LGBT Equality, and New York State Academy of Family Physicians.




Full Article

This entry was posted in Health Care and tagged . Posted by Thaddeus Mason Pope, JD, PhD. Bookmark the permalink.

10/14/2018

The U.S. Uniform Determination of Death Act: Past, Present, and Future

Join me at the VIII International Symposium on Brain Death and Disorders of Consciousness, in Havana, on December 4-7, 2018, to discuss "The U.S.Uniform Determination of Death Act: Past, Present, and Future."

Full Article

This entry was posted in Health Care and tagged . Posted by Thaddeus Mason Pope, JD, PhD. Bookmark the permalink.

10/13/2018

Jahi McMath – Status of Her Lawsuits

Since 2013, there have been six lawsuits contesting the death of Jahi McMath. Now, there is only one. The Alameda County medical malpractice case was the primary case in which the family of Jahi McMath challenged the legitimacy of her determination o...

Full Article

This entry was posted in Health Care and tagged . Posted by Thaddeus Mason Pope, JD, PhD. Bookmark the permalink.

10/12/2018

Ending Medical Self-Regulation: Does Less Physician Control Improve Patient Safety and Protect Patient Rights?

Here is video from a webinar that I did at Michigan State University Center for Ethics and Humanities in the Life Sciences on Wednesday. The title is "Ending Medical Self-Regulation: Does Less Physician Control Improve Patient Safety and Protect ...

Full Article

This entry was posted in Health Care and tagged . Posted by Thaddeus Mason Pope, JD, PhD. Bookmark the permalink.

10/11/2018

Shared Decision Making & Advance Care Planning: Using Decision Aids to Improve Patient Safety

Thank you ACP Michigan for inviting me to speak with passionate advance care planning professionals about "Shared Decision Making & Advance Care Planning: Using Decision Aids to Improve Patient Safety."

Full Article

This entry was posted in Health Care and tagged . Posted by Thaddeus Mason Pope, JD, PhD. Bookmark the permalink.

10/09/2018

Federal Appellate Court Allows Lawsuit for Unilateral DNR

The U.S. Court of Appeals for the 11th Circuit has affirmed the partial denial of a prison warden's motion to dismiss a lawsuit brought by an inmate's family after the warden unilaterally entered a do not resuscitate order and directed removal from artificial life support.

Marquette F. Cummings, Jr. was an inmate at St. Clair Correctional Facility in Springville, Alabama. He was seriously stabbed in the eye and was airlifted  to University of Alabama at Birmingham Hospital.

His family filed a federal lawsuit based on the following conduct at the hospital. Dr. Sherry Melton, a medical supervisor at UAB Hospital, changed Cummings's code status to Do Not Resuscitate without authorization from Gaines or any other family member and without notifying Gaines and Cummings's family of the decision.

Plaintiffs allege that Dr. Melton relied upon statements from the St. Clair warden to change Cummings's code status to DNR even though Gaines and several other family members were at the hospital. Plaintiffs further allege that “Warden Davenport authorized UAB medical personnel to stop giving Cummings medication and to disconnect the life support machine.” Plaintiffs allege that contrary to Gaines's wishes, and “[b]ased on [the] directive from Warden Davenport, Cummings was taken off of life support....” Cummings passed away just hours after UAB medical personnel removed his life support.

Finding that the warden lacked any authority under Alabama law to make those treatment decisions, the court found the warden was not entitled to qualified immunity, and denied the warden's motion to dismiss the Estate's § 1983 claim based on Warden Davenport's alleged deliberate indifference to Cummings's serious medical need in violation of the Eighth Amendment.



Full Article

This entry was posted in Health Care and tagged . Posted by Thaddeus Mason Pope, JD, PhD. Bookmark the permalink.