by Craig Klugman, Ph.D.
This week, California governor Jerry Brown signed Senate Bill 277. This law mandates vaccinations for all children who attend a school (public or private) in the state. The only exemption is when a physician certifies that a vaccine “is not considered safe for the child.” The big change in this new law is the removal of the “personal belief” exemption from vaccination. No longer can a religious or philosophical belief exempt a child from receiving an immunization.
California has been at ground zero for conversations about vaccination. Earlier this year, the Disneyland park in Anaheim, California was the center of a massive national measles outbreak among unvaccinated children.…
Here is the abstract:
This issue’s “Legal Briefing” column covers recent legal developments involving medical decision making for incapacitated patients who have no available legally authorized surrogate decision maker. These individuals are frequently referred to either as “adult orphans” or as “unbefriended,” “isolated,” or “unrepresented” patients.
The challenges involved in obtaining consent for medical treatment on behalf of these individuals have been the subject of major policy reports. Indeed, caring for the unbefriended has even been described as the “single greatest category of problems” encountered in bioethics consultation.
In 2012, JCE published a comprehensive review of the available mechanisms by which to make medical decisions for the unbefriended. The purpose of this “Legal Briefing” is to update the 2012 study. Accordingly, this “Legal Briefing” collects and describes significant legal developments from only the past three years.
My basic assessment has not changed. “Existing mechanisms to address the issue of decision making for the unbefriended are scant and not uniform.” Most facilities are “muddling through on an ad hoc basis.”
But the situation is not wholly negative. There have been a number of promising new initiatives. I group these developments into the following seven categories:
- Increased Attention and Discussion
- Prevention through Better Advance Care Planning
- Prevention through Expanded Default Surrogate Lists
- Statutorily Authorized Intramural Mechanisms
- California Litigation Challenging the Team Approach
- Public Guardianship
- Improving Existing Guardianship Processes
by Jennifer Chevinsky, BS
A medical student comes into the hospital wearing his favorite pair of old, ripped, dirty jeans.
A physician ‘pimps’ a medical student and publicly shames her when she doesn’t know the answer.
A nurse tells the patient that he really does not like working with the case manager on the medical service.
A resident presents her patient to the attending, including a complete physical exam that she did not perform.
In recent years, increased focus has been placed on the concept of professionalism in medicine by the Association of American Medical Colleges (AAMC), Liaison Committee for Medical Education (LCME), Accreditation Council of Graduate Medical Education (ACGME), and Accreditation Council of Continuing Medical Education (ACCME).…