Private Practice -- Pulling the Plug

On episode 318 of Private Practice, a woman's husband and DPAHC decides to remove his comatose wife's ventilator.  But the wife is a surrogate mother and the parents of the fetuses want the patient's life support continued until the babies can be delivered.  (This is legally required in most jurisdictions.)  What I liked was at 8:10, during a confrontation between the husband and the parents, the parents say "we got a lawyer."  There is a dramatic pause and jaw dropping.  

Palliative Care Grand Rounds

April 2010's Palliative Care Grand Rounds is now up over at Tim Cousounis' Palliative Care Success blog.  I will host next month (first Wednesday in May). 
  

Kaylee Vitelli - Unilateral Withdrawal of Ventilator

Jason Wallace and Crystal Vitelli are considering suing Toronto's Hospital for Sick Children after providers removed their 14-month-old, Kaylee, from a ventilator without their approval.  (Toronto Sun)  


The parents explained that they watched helplessly as their daughter fought to breathe on her own for 27 hours.  (The parents posted on their Facebook page a video of Kaylee apparently struggling to breathe.)  "We walked back into the room to see our daughter struggling, and I mean struggling in a torturous way."  Both parents are calling for an internal investigation by the Hospital for Sick Children.  They are also considering complaining to the Ontario Association of Physicians and Surgeons and the Attorney General.  (680 News)  

As she famously did last year, Kaylee managed to pull through and is expected to be released in a few days.

New Case -- Bennett v. Ruby Memorial Hospital

In mid-February 2010, 40-year-old Rebecca Bennett went into a coma due to complications from diabetes.  After a few weeks, the ethics committee at Ruby Memorial Hospital in West Virginia decided that it would stop Bennett's dialysis on March 27, despite the expressed objections of Bennett's surrogate and daughter, Sierra Kisner.  

ADF filed a complaint and secured an extension of the withdrawal date until April 9.  But why didn't they shoot for a longer period?  Apparently, because the hospital has some grounds for replacing the surrogate, ADF's BATNA was not a permanent injunction.

Five Big Myths of Advance Care Planning and How to Stay Anchored in Reality

Sponsored by the ABA Health Law Section, the Senior Lawyers Division and the ABA Commission on Law and Aging

Tuesday, April 13 at 2:00-3:30pm Central

This complementary teleconference (and podcast will be posted here afterwards) will address the five biggest myths that plague advance care planning and how to steer clear of them and make advance care planning more effective.

Myths:

1. People should use their state’s official advance directive form(s).
2. Your advance directive should include as specific instructions as possible.
3. Advance Directives are legally binding so doctors have to follow them.
4. Doing everything possible for dad means keeping dad alive at all costs.
5. A written advance directive is better than talk.

Since the mid-1970s, health care advance directives have become the central legal tool to make sure one’s health care wishes are known in a formal way and, it is hoped, followed. However, clinical realities and the medical-social sciences literature over the last 30 years cast doubt on the effectiveness of advance directives. The reality is that directives are just a part of a process of advance care planning that requires more than just a form and a signature. Sometimes forms get in the way.

Panelists:

• Richard Payne, MD, Professor of Medicine and Divinity, Esther Colliflower Director, Duke Institute on Care at the End of Life, Duke University Divinity School
• Charles P. Sabatino, J.D., Director of the American Bar Association’s Commission on Law and Aging