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Blog Posts (3443)

September 21, 2016

Introducing New Deliberative Scenario and Teacher Companion from the Bioethics Commission: “Return of Genetic Research Results”

The Presidential Commission for the Study of Bioethical Issues (Bioethics Commission) has released two new educational materials, “Deliberative Scenario: The Return of Genetic Research Results” and “Teacher Companion for Deliberative Scenario: Return of Genetic Research Results.”
September 21, 2016

The High Price of Free Lunch

Once again: correlation does not equal causation. And it is possible that companies give lunches to physicians who are already inclined to prescribe their products, or who are already high prescribers. But why should we leave any of this up … Continue reading

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September 21, 2016

Better Decision Making for Incapacitated Patients without Surrogates

This afternoon, I am making a presentation to the North Dakota Long Term Care Association on "Better Decision Making for Incapacitated Patients without Surrogates." I prepared a new 300 slide deck and have posted it here.  I will also be building...
September 20, 2016


The capturing on video of the recent death of Terence Crutcher due to a police shooting has renewed concern about the respect paid to black lives in U.S. society.  ReflectiveMedEd reprints these remarks from a #WhiteCoats4BlackLives event at the Loyola University Chicago Stritch School of Medicine which was part of a national observance that gathered […]
September 20, 2016

Minnesota Ethics Law & Futility Symposium

Join me, Mitchell Hamline School of Law, and Children's Minnesota on November 18 for "Ethics, Law, and Futility" Symposium.
September 19, 2016

Late Term Zika Abortions: Thankfully not Euthanasia

If I were the editor of a recent Newsweek article by Cornell Law Professor Sherry F. Colb, the above title would have been my choice for her article. I must encourage you to read the actual article, lest you believe that the summary that follows is somehow taken grossly out of context. Her concern is that a late term abortion to terminate the life of... // Read More »
September 19, 2016

Ethically Sound Episode 2: Ethics and Ebola

Since the Bioethics Commission was established through Executive Order in 2009 by President Barack Obama, it has released 10 reports on a variety of ethically challenging topics, including synthetic biology, neuroscience, and whole genome sequencing, among others. The Bioethics Commission is excited to release a new podcast series, Ethically Sound. Each episode features one of […]
September 19, 2016

Oregon Court Denies Right to Advance VSED

I have written several times about the Margot Bentley case in which the BC courts denied a dementia patient's request (in her advance directive) to not be fed in the advanced stages of Alzheimer's. Now, an Oregon court has reached a similar decision. ...
September 18, 2016

Virginia Legislature May Adopt Texas Futility Law

Earlier this year, the Virginia Joint Commission on Health Care (comprised of 18 legislators) was tasked with studying the current legal and regulatory environment on life-sustaining medical treatment, particularly legal requirements regarding disagreements over medical appropriateness. 

The JCHC determined treatment decision conflicts to be frequent.  Data collected in July and August 2016 show 274 cases with ethics committee involvement from 44 reporting hospitals over the past year (roughly 6 per hospital per year).  93% were resolved through consensus, agent replacement, transfer, or death.

In September, a broadly representative JCHC working group made several recommendations for legislative changes that would make Virginia law much like Texas law.  I am delighted to see several of my articles cited in the report.  But I have submitted comments sharing my concerns about the fairness and due process problems with the Texas mechanism.    

Public comments on the proposed options are due to JCHC by September 28.  The comments will be considered by the JCHC at its October 5 meeting.

The complete list of recommendations is:

1. Require hospitals to maintain written policies on life-sustaining treatment decision conflict resolution procedures
2. Require hospitals to take standard minimum steps in cases of life sustaining treatment decision conflict
3. Provide qualified permission to physician to cease inappropriate treatment after 14 days
4. Provide physician immunity for following requirements
5. Stipulate that all actions under this section must conform to federal non discrimination standards
6. Revise “life-sustaining care” term and definition
7. Eliminate Durable Do Not Resuscitate Orders from applicable documents within § 54.1-2990
8. Form Working Group to study health care decisions more broadly, focused on preventing/improving resolution of treatment decision conflicts

September 17, 2016

Deuell v. Texas Right to Life Committee - Lawsuit over Texas Advance Directive Act

In 2014, Texas state senator Bob Deuell was running for reelection.  For years, Deuell was one of the most active legislators working to improve the fairness of the "futility" provisions in the Texas Advance Directives Act.

But to improve TADA meant preserving it.  And that was contrary to the mission of the Texas Right to Life Committee.  They attacked Deuell and he was not reelected.  

Specifically TRLC ran ads that said:  "Before you trust Bob Deuell to protect life, please listen carefully.  If your loved one is in the hospital, you may be shocked to learn that a faceless hospital panel can deny life-sustaining care . . . . Bob Deuell sponsored a bill to give even more power to these hospital panels over life and death for our ailing family members.   Bob Deuell turned his back on life and on disabled patients."

Deuell sent cease and desist letters to the radio stations and they pulled the ads.  But TRLC then sued Deuell for tortuous interference with contract.  

This week, the Texas Court of Appeals affirmed trial court’s denial of Deuell's motion to dismiss pursuant to the Texas Citizens Participation Act.  So, TRLC's lawsuit will proceed.