Tag: syndicated

Blog Posts (1488)

January 30, 2015

How Generously Does Your State Reimburse for Medicaid?

A while ago, I wrote a post on how hard it can be for Medicaid recipients to get medical appointments, because so many physicians limit the number of Medicaid patients they see. They limit the number because Medicaid reimbursement is … Continue reading

The post How Generously Does Your State Reimburse for Medicaid? appeared first on PeterUbel.com.

January 30, 2015

Bad Healthcare Surrogates Kill Patient for the Money - Victorino Noval

Three years ago, I blogged about the Victorino Noval case.  The case (actually multiple cases) are still being litigated.  An appellate decision issued a few days ago summarizes the key alleged facts.  

Three siblings, Lourdes, Tania, and Victor, allegedly directed a hospital to take their father, Victorino Noval, off life support and administer fatal doses of morphine, without the consent of their brother, Hector Noval (Hector), whose permission was required under a durable power of attorney for healthcare. Lourdes, Tania, and Victor also allegedly absconded with cash and other personal property of Victorino while he was hospitalized.


"Decedent was a fully functioning 78-year-old with about $60 million in assets and $3 million in annual income. On April 28, 2010, decedent was admitted to the hospital with pneumonia. He was intubated and, when sedated, became temporarily incapable of making his own medical decisions. By the end of the 10-day hospitalization, decedent had overcome the pneumonia, had had his intubation removed, had become distress free, and could make 'eye contact for more than 10 seconds.'"


"Nonetheless, Lourdes, Tania, and Victor ordered hospital staff to terminate decedent’s treatment and administer fatal doses of morphine on May 7, 2010, causing his death that day. The only reason the threesome so directed hospital staff was to hasten decedent’s death and collect their inheritances."


"According to Hector, decedent had a durable power of attorney for health care (health care power) that named Hector and Lourdes as joint attorneys-in-fact, such that the unanimous consent of the two of them was required for action to be taken. However, Lourdes, Tania and Victor falsely represented to hospital staff that Hector concurred in their decision to end decedent’s life, and concealed the existence of the health care power from Hector himself. Furthermore, at the same time that they directed hospital staff to withdraw decedent’s treatment and end his life, they misrepresented to Hector that decedent’s treatment would be continued indefinitely."

"Lourdes, Tania and Victor met with hospital staff on May 4 and 5, 2010 and represented that the whole family, Hector included, 'desired terminal extubation for decedent.' They also represented to hospital staff, on May 5 and 6, 2010, that Hector 'was a violent person, a drug addict, someone with paranoid personality,' who had 'threatened violence’ against them . . . and that they were afraid of him.' Hector further alleged that his siblings had represented to hospital staff that he had ulterior motives and was unfit to make health care decisions for decedent."


"Lourdes, Tania and Victor met with hospital staff on May 7, 2010 for 'the planned withdrawal of decedent’s treatment and fatal injections or morphine[.]' Even though they were informed that decedent was improving, they declined 'the opportunity to . . . cancel decedent’s planned death[.]'  Moreover, they again falsely informed hospital staff that Hector was in favor of the plan, and said he simply elected not to be present. To the contrary, Hector was not even aware of the plan. Hospital staff removed the ventilator, withdrew oxygen support, removed the nutritional tubes, and administered fatal doses of morphine. According to Hector, decedent would have lived absent these acts."


January 29, 2015

Wall Street Journal readers weigh in on PAS

Last Saturday, the Wall Street Journal carried an excellent op-ed piece, “Dr. Death Makes a Comeback” (subscription required), by Dr. Paul McHugh, former chief psychiatrist at Johns Hopkins Hospital.  In it, Dr. McHugh opposes physician-assisted suicide (PAS), making three key points: The practice will tend to spread beyond terminally ill people to those who are “treatable but mentally troubled.”  He appeals to the experience in... // Read More »
January 29, 2015

V-Ticket to Ride

by Sean Philpott-Jones, Director of the Center for Bioethics and Clinical Leadership I haven’t been to Disneyland since my senior year in high school, and I’ve actually never visited one of the Disney World resorts. Frankly, I never really cared for the noise, the crowds and the artificiality of the Disney parks. The fact that […]
January 29, 2015

Oklahoma Medical Treatment Laws Information Act - The Disclosures

Last year, I blogged about the 2014 Oklahoma  Medical Treatment Laws Information Act.   This law was enacted to educate clinicians about their duties, and patients about their rights, under the 2013 Oklahoma Nondiscrimination in Treatment Ac...
January 28, 2015

End of life conversations

Having conversations with patients about death are difficult. Sometimes I think we need to talk, but the patient or family does not seem to be ready. I suspect that sometimes the patient wants to talk, but I am not sensitive to that. Sometimes a patient clearly has a terminal illness, but the patient or the family is in denial. Sometimes different physicians approach the patient... // Read More »
January 28, 2015

Malpractice Reform Won’t Save Money

Two problems loom large over the American medical care system. First, we spend outrageous amounts of money on healthcare, with too many patients receiving too many services at too high a price. Second, our malpractice system is an international embarrassment, … Continue reading

The post Malpractice Reform Won’t Save Money appeared first on PeterUbel.com.

January 28, 2015

Texas Advance Directives Act - 2015 Legislative Session

The 2015 legislative session (the 84th) in Texas has just begun and some are getting ready to again tackle the Advance Directives Act.

TADA was last amended in 2003.  Multiple bills were advanced in 2007, 2009, 2011, and 2013.  But none were enacted.  Get ready for round five.    


In the January 2015 issue of TEXAS MEDICINE:  "In anticipation of another round of debates over end-of-life care, TMA's workgroup dedicated to the issue will work to protect physicians' ability to do what's best for patients in their final days."


Defending TADA is part of the Texas Medical Association's strategic roadmap for state advocacy initiatives, Healthy Vision 2020 (2d ed.).


"Legislation has been introduced over the past four legislative sessions that would instead require indefinite treatment with no provision for the physician exercising ethics or moral judgment. TMA has opposed these proposals because they would prolong unnecessary — and often painful or even torturous — care that cannot prevent but can only prolong death. They would also require physicians, nurses, and other health care professionals to provide medically inappropriate care, even if that care violates medical ethics or the standard of care. They also would set a dangerous precedent for the legislature to mandate the provision of physician services and treatments that may be medically inappropriate, outside the standard of care, or unethical."


January 27, 2015

Academic Medicine: In need of an examination?

Being a physician in an academic setting, my attention was drawn to this recent article in Academic Medicine: “Time Well Spent: The Association Between Time and Effort Allocation and Intent to Leave Among Clinical Faculty” by Pollart et al. I had mixed gut reactions to this topic; ranging from the notion that this is an awesome topic long overdue for attention, to the questioning of... // Read More »
January 27, 2015

Have a Miscarriage and Go to Jail? Potential Consequences of Personhood Amendments

Bertha Alvarez Manninen

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