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. Â 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. Â 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. Â 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. Â 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.
Larry Weiss – The Right To Die (handout)
Pearls
- 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) –Â 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)
- Guardian
- Adult Spouse
- Adult Child
- Parent
- 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!!
