Saturday, March 28, 2015

Intensive Care Hotline Resource for Families of Critically Ill Patients

Most of my blogging on this site, as well as my articles and book chapters, and  all concern legal rights and duties concerning medical treatment at the end of life.  

But most of the communication, negotiation, and mediation about end-of-life treatment conflicts never gets (or needs to get) framed in legal terms.  Disputes are usually resolved way upstream.  Most hospitals have ethics consults, ethics committees, ombudsmen, patient advocates, and/or other resources.  

One external resource for families of critically ill patients in intensive care is the Intensive Care Hotline.  The printed and live consulting offerings are designed to help families: 

  • Ask the doctors and the nurses the right questions
  • Discover the many competing interests in Intensive Care and how treatment may depend on those competing interests
  • Stop being intimidated by the Intensive Care team and how you will be seen as equals
  • Get "behind the scenes" insight to understand what is really happening in ICU
  • Have peace of mind, power, influence decision making and stay in control of their Family's and their critically ill loved one's destiny

Friday, March 27, 2015

$1 Million Lawsuit over Unilateral DNR Order - Luong v. Toronto East General Hospital

Robert Cribb at the Toronto Star has been a diligent and articulate investigative reporter covering end-of-life medical treatment disputes.  This week, he reports on a new lawsuit filed by the family of Canh Luong against Toronto East General Hospital.

94-year-old Luong was admitted to TEGH in September 2014.  While clinicians recommended comfort measures, that plan was rejected by her family.  But by October 2014, hospital physicians proceeded without family consent.  Physician Alvin Chang transferred Luong from the ICU to a general ward of the hospital.  And he wrote a DNR order without the family's consent.

The case is remarkable for two reasons.  First, after Cuthbertson v. Rasouli, many Canadian clinicians have become more deferential to family wishes.    

Second, the lawsuit alleges that Dr. Chang did not even delay implementing the unilateral decision for a mere 24 hours to allow the family the opportunity to seek a court order or a transfer to another facility.  A brief waiting period is a standard part of the dispute resolution procedures in hospital policies, in model medical society policies, and in state laws.
  

Lisa Avila Family Now Accepts Death Diagnosis, Agrees to Stop Physiological Support

It looks like the brain death dispute between the family of Lisa Avila and Anaheim Regional Medical Center is coming to a consensual conclusion.

After obtaining a TRO, the family was able to bring in their own neurologist.  Like the ARMC physicians, the independent neurologist did not detect any brain activity.  The family now plans to take Avila off of life support around 5 p.m. Friday. (ABC News)

The family reported on its fundraising website:  "So now the family does have a little more piece of mind in regards to trusting a third party Dr, that is not affiliated with the hospital. We are currently now working with the staff of the hospital in trying to agree to terms of a time frame of the disconnection of the plug from Lisa's Life support. This is not something that is very easy for the family still to accept, although the fact of the reality is just setting in."

Thursday, March 26, 2015

Biosecurity in a Globalised World: The Adoption of the Revised International Health Regulations – 10 Years On

Biosecurity in a Globalised World: The Adoption of the Revised International Health Regulations – 10 Years On

In 2015 it will be 10 years since the adoption of the revised International Health Regulations (IHR). To mark this important anniversary, QUT’s Australian Centre for Health Law Research is pleased to invite you to Biosecurity in a Globalised World: The Adoption of the Revised International Health Regulations – 10 Years On.
The conference will be hosted by the Australian Centre for Health Law Research at Queensland University of Technology’s Gardens Point campus in Brisbane from 27-28 July 2015.
The conference will provide a forum for scholars and policy makers to discuss and present on the progress achieved through the IHR to date, and the important work yet to be done.
The keynote address will be delivered by Professor Lawrence O. Gostin, Founding O’Neill Chair in Global Health Law, Georgetown University, USA.
Themes to be discussed at the conference include:
  1. Development of IHR core capacities
  2. Regulatory responses
  3. Securitisation of infectious disease outbreaks
  4. Human rights
Papers from all disciplines and areas of expertise are welcome.

For further information please visit http://ihr2015.com/

If you have any questions, or require any assistance, please contact us at: ihr2015@qut.edu.au.

For updates on the conference follow @HealthLawQUT
Official conference hashtag: #IHR2015
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IHR 2015 Conference Organisers

Dissecting the Ethics of Organ Donation - 2nd Annual Islamic Bioethics Workshop

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The Initiative on Islam and Medicine’s (II&M) 2nd Annual Islamic Bioethics Workshop, titled “Dissecting the Ethics of Organ Donation,” will be held June 5-7, 2015, at the University of Chicago.

Co-sponsored by the American Islamic College, the 3-day workshop will provide an in-depth conceptual introduction to the field of Islamic bioethics and examine the practical and theological ethics of organ donation in Muslim contexts and from an Islamic perspective. 
A brochure is downloadable here.  

Wednesday, March 25, 2015

Court Orders Hospital to "Treat" Dead Woman - Avila v. ARMC

Following the procedural path set by the Jahi McMath case in 2013, the family of Lisa Avila has obtained a TRO "precluding" Anaheim Regional Medical Center from "removing Lisa Avila from the ventilator or ending any of the current treatment."  

The family is going to get an "independent" exam to confirm the diagnosis of death by neurological criteria.

Tuesday, March 24, 2015

Medical Futility Lawsuit Proceeds against Yale - Marsala v. Yale New Haven Hospital

In 2008, I reviewed all the medical futility lawsuits that I could find.  I looked at both ex ante cases (for injunctions) and ex post cases (for damages).  With respect to the ex post cases, I concluded that the single most successful theory has been for emotional distress (IIED or NIED).

Consistent with my findings, in late 2013, the Connecticut  Superior Court denied Yale New Haven Hospital's motion to dismiss an intentional infliction of emotional distress (IIED) claim brought by the family of Helen Marsala.  (I blogged about this case almost exactly a year ago, when I spoke at Yale.)


In Marsala v. Yale, the family alleges that clinicians removed Helen's ventilator without consent and over their objections.  The court ruled that a jury could find that "terminating a patient's life support with an awareness of her contrary wishes constitutes unacceptable behavior and would readily be considered extreme and outrageous."


But while the family defeated Yale's motion to dismiss, it could not defeat Yale's motion for summary judgment.  Connecticut law apparently does not support "bystander" IIED claims.  This week, Yale successfully moved for summary judgment' on the IIED claim.  The case is still proceeding on a number of other counts.


California Lawsuit for Not Honoring POLST

The family of Mary Virginia Schuller has just filed a lawsuit in Los Angeles Superior Court against a long term care facility for, among other things, failing to honor her June 2014 POLST.  

Administratively, CMS has already concluded that the facility violated Ms. Schuller's rigths under Medicare/Medicaid Conditions of Participation.  The civil damages claims are for:

  • ELDER ABUSE & NEGLECT
  • NEGLIGENCE
  • NEGLIGENT HIRING, SUPERVISION, & RETENTION
  • VIOLATION OF RESIDENTS RIGHTS
  • NEGLIGENT INFLICTION OF EMOTIONAL DISTRESS
  • WRONGFUL DEATH