August 2005

NEWS FROM ATTORNEYS GENERAL OFFICES

  1. Maryland Attorney General J. Joseph Curran has made living wills and advance directives available in Spanish on his website and by mail. The website also includes opinions from the office on end of life care and General Curran?s Policy Study on Alzheimer?s Disease Care. The most recent opinion explains why hospitals may not have a policy that ban implementation of telephonic DNR orders issued by a patient?s physician.

  2. Missouri Attorney General Jay Nixon is partnering with the National Hospice and Palliative Care Organization and Lt. Gov. Peter Kinder to host a statewide summit for legislators and other policy makers in October to review the state?s laws surrounding end of life issues. The day-long policy summit, to be held in Jefferson City on October 9, will be the culmination of a series of town meetings held in July, August, and September hosted by the End of Life Coalition. More information is available at the website. General Nixon has also begun an initiative, Operation Grave Concerns, to target those providing pre-need funeral plans and cemetery headstones to Missouri consumers who are not abiding by Missouri law requiring monies to be placed in trust accounts. More information on the criminal and civil actions being taken is available at the website.

COURT DECISIONs

  1. The August 24 issue of the New York Law Journal, reported on a decision by a judge in Brooklyn, New York, in Skylarsky v. New Hope Build Center (registration required), No. 12023/01, which held that a husband had a duty to provide medical care to his mentally troubled wife and that his failure to do so prior to her suicide rendered him negligent.

  2. A court in the United Kingdom has upheld the General Medical Council?s 2002 guidance concerning end of life issues.

PROPOSED LEGISLATION

  1. S. 347 (and its companion HR 2058), dealing with advance health directives, are being championed by a number of organizations.

OTHER DEVELOPMENTS OF INTEREST

  1. Supreme Court nominee John J. Roberts, Jr., is being questioned by senators about end of life issues. According to an article in the August 10, 2005, issue of the New York Times by Sheryl Gay Stolberg, when asked by Senator Ron Wyden (D-Ore.) about whether Judge Roberts felt it was constitutional for Congress to intervene in an end-of-life case with a specific remedy, Judge Roberts replied that Congress should not prescribe particular remedies in particular cases.

  2. According to recent press releases from the National Center on Addiction and Substance Abuse at Columbia University concerning its report ?Under the Counter: The Diversion and Abuse of Controlled Prescription Drugs in the U.S.?, more than 15 million Americans abuse opoids, depressants, and stimulants with teen abuse having tripled in ten years. Another finding was that only about half of the pharmacists surveyed had received training in preventing prescription drug diversion or identifying abuse or addiction since pharmacy school. Less than 20% of the physicians surveyed reported receiving medical school training in identifying prescription drug abuse and addiction and less than 40% received any medical school training in identifying prescription drug abuse and addiction.

  3. Two recent articles have cited the letter to DEA signed by thirty-one Attorneys General. The August 19, 2005, issue of the Orange County Register carried an opinion piece by Drs. Michael Glueck and Robert Cihak titled ?Inflicting Pain? (registration required). The August 25, 2005, issue of the Roanoke Times included an article by Ronald Fraser, titled ?Patients Feel Pain When DEA Targets Doctors?.

  4. Drs. Glueck and Cihak?s August 15, 2005, article titled ?The War Against Pain-Treating Drugs: Another Failed Prohibition? is available at the Jewish World Review.

  5. The August 20, 2005, issue of the Journal of Clinical Oncology includes an article by researchers in Canada and Australia, titled ?Dignity Therapy: A Novel Psychotherapeutic Intervention for Patients Near the End of Life?. The article demonstrates that dignity therapy, which is designed to address psychosocial and existential distress among terminally ill patients, is a promising intervention for easing suffering and distress at the end of life.

  6. The American Heart Association and the American College of Cardiology has released new guidelines about heart failure. The guidelines include recommendations that physicians provide information on end of life issues. The guidelines also recommend that cardiologists broach the subject of hospice care.

  7. Andrea Petersen wrote an article, ?A new approach for the sickest babies?, regarding a new approach to caring for terminally ill infants in neonatal intensive care units. It is now more frequent that physicians are prescribing palliative care for these babies so that they can die without pain in their parents? arms. In a related development, The Centers for Medicare and Medicaid Services recently began to allow states to apply for new waivers that allow for improved, more comprehensive care for children with life-threatening conditions. The new waiver, which will run through June 2007 under the authority of section 1915(b) of the Social Security Act, is based on a model developed by the Children?s Hospice International. Florida is the first state to begin the new program.

  8. Australian newspapers have carried articles noting the divergence of public opinion on a decision to remove a feeding tube from Maria Korp. The decision was made by a public official (public advocate) who had been appointed her guardian. Mrs. Korp was attacked in her garage last February, strangled by her husband?s lover, and placed in the trunk of her car. She has been in a persistent vegetative state since then. Mr. Korp, who was implicated in the attack, committed suicide shortly after Mrs. Korp?s death in early August.

  9. The July-August issue of Health Affairs carries an article by geriatrician Jerald Winakur, titled ?What Are We Going to Do With Dad??. It is a highly personal account of Dr. Winakur?s own struggles concerning the care of his father who has dementia. The same issue contains several other articles concerning end of life treatment.

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