Legal Briefing on Advance Care Planning

The latest issue of the Journal of Clinical Ethics should be out.

In this issue - 20(4) - I have a article (pages 289-296) that reviews recent legal developments concerning advance care planning.  I group these into six categories: 

1.     General healthcare decisions statutes

2.     Statutes mandating compliance with advance directives in long-term care facilities

3.     “Right-to-know” informed consent laws

4.     Advance directive registries

5.     POLST laws

6.     Laws mandating insurance coverage for ACP

Ariel Sharon Four Years Later: ‘Probably Comatose for Life’

Former Israeli Prime Minister Ariel Sharon suffered a stroke four years go that has left him comatose, a condition that is unlikely to change. Sharon, now age 81, suffered a mild stroke in December of 2005, followed by a massive one in January 2006 from which he has never regained consciousness.


Close friend and former advisor Dov Weisglass told the Associated Press that although Sharon's vital signs are good, there are no signs he is progressing out of his coma, despite several rumors over the years that were based on involuntarily movements of his eyes. (Arutz Sheva)

The Impact of Ron Houben in the Media

As widely reported throughout the world, over the past several weeks, Belgian crash victim Rom Houben appeared to begin communicating from a presumed vegetative state of 23 years.  Coma scientists in Europe promoted Houben's alleged use of a letter board to tap out elaborate sentences, and claimed more than 40 percent of patients presumed in a PVS or MCS might be fully conscious. 

As expected, many families (like that of Lisa Smith) of brain-trauma patients found their hopes rising anew.  "It's scary for people to think of someone 'in there' and being disconnected" from life support.  (Dr. Steven Ringel, a neurology expert with the University of Colorado Denver School of Medicine).   (Denver Post)


Are families being more aggressive now?  Are they less willing to accede to provider recommendations to move to palliative care?  Are providers themselves less willing to make such recommendations?