Legal Update: Medical Futility

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Legal Update Medical Futility

• Thaddeus M. Pope, J.D., Ph.D.
• Widener University Law School

ASBH Annual Meeting (San Diego) October 21, 2010
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• Baseline
• Courts (2009-2010)
• Legislation (2009-2010)

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• Baseline

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• Bad
• law

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Mass. Med. Society (Nov. 2008)
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Consensus
Intractable
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• Remove the __, and I will sue you.

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• Why they follow the instructions of SDMs
  instead of doing what they feel is appropriate,
  almost all cited a lack of legal support.

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• Court Cases

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• Damages
• Injunctions
• Surrogate selection

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• Damages

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• Providers have won almost every single damages
  case brought after unilateral w/h, w/d
• State HCDA
• Battery
• Medical malpractice
• Informed consent

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• Providers typically only lose on claims for IIED
• Secretive
• Insensitive
• Outrageous

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• Luce is confirming the trend of unsuccessful
  lawsuits against providers

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• Risk gt 0

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• But the process itself can be punishment
• Even prevailing parties pay transaction costs

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• Injunctions

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• Courts frequently grant temporary injunctions to
  preserve status quo
• But patients often die before adjudication on
  the merits

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• amex

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Ruben Betancourt vs. Trinitas Hospital
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• 73yo male
• PVS
• COPD
• End-stage renal disease
• Hypertensive cardiovascular disease

• Stage 4 decubitus ulcers
• Osteo-myeletitus
• Diabetes
• Parchment- like skin

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• Intramural process
• No consensus
• Unilateral withdrawal
• DNR order written
• Dialysis port removed

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• January 21, 2009
• Jacqueline files complaint
• January 23, 2009
• Court issues TRO
• February 10, 2009
• Court extends TRO

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• January February 2009
• Evidentiary hearings
• Medical expert witnesses
• Family witnesses

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• March 4, 2009
• Permanent injunction on the merits
• August 2009
• Appeal NJHA, MSNJ, NJP, GNYHA

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• August 13, 2010
• Appellate court refuses to reverse

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• Surrogate Selection

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• A proxy shall act in accordance
• directive . . . decisions
• the makers . . . wishes
• makers best interests

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• Helga Wanglie
• (Minn. 1991)

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Dorothy Livadas
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• Bernstein v. Superior Court of Ventura County
  (Feb. 2, 2009).

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• Court to
• Barbara Howe
• Your own personal issues are impacting your
  decisions
• Refocus your assessment

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Ontario Capacity and Consent Board
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• Limitations of surrogate replacement

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• Legislation

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Texas as model
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S.B. 1114 (Mar. 2009)
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Thaddeus Mason Pope Associate Professor of
Law Widener University School of Law 4601 Concord
Pike ? L325 Wilmington, DE 19803 T
302-477-2230 F 901-202-7549 E
tmpope_at_widener.edu W www.thaddeuspope.com