Dr. Larry Weiss is a professor of Emergency Medicine at the University of Maryland , who also practiced as a defense attorney for a number of years in the state of Louisiana defending emergency physicians. His passion for advocacy and health care policy has taken him around the world where he has lectured on a variety medico-legal topics including end-of-life care. In this lecture Dr. Weiss discusses the legal history of, “The Right to Die” and how it specifically impacts physicians practicing in the United States. The second half of this talk specifically discusses legal issues related to patients in the state of Maryland.
Understanding the legal considerations surrounding end-of-life care is imperative in the ICU. So sit back, relax, and listen closely – so that you are well prepared for the next time you (and your patient) are faced with some of the most difficult decisions in medicine.
- A surrogate can be appointed to make medical decisions as a competent person would otherwise do
- State dependent
- In re Quinlan. 70 N.J. 10, 355 A.2d 647 (1976)
- The removal of feeding tubes/mechanical ventilation is not considered homicide
- The family may transfer a patient to a different hospital who will comply with their wishes
- For example, in the state of NY a surrogate CAN NOT make end-of-life decisions
- It is acceptable to require “clear and convincing evidence” of a patient’s wishes for removal of life support
- Cruzan v. Director. 497 U.S. 261 (1990)
- Led to the development of advance directives
- Physician assisted suicide
- Only legal in the states of Oregon (Death with Dignity Law) & Washington
- Vacco vs. Quill. 521 U.S. 793 (1997), Washington v. Glucksberg 521 U.S. 702 (1997)
- Gonzales v. Oregon, 546 U.S. 243 (2006) – Supreme Court: It’s ok for states to ban physician assisted suicide
- Surrogate order in the STATE of MARYLAND
- Health care agent (as designated in an advanced directive)
- Adult Spouse
- Adult Child
- Adult Sibling
- Friend or relative
Remember – this lecture and post do not represent legal advice, but rather as a reminder to make sure you know the laws that affect where you practice!!
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