WHAT CAUGHT MY EYE

ADVANCE DIRECTIVE REGISTRIES

Lawyer and law professor Thaddeus Pope, whose own blog is an invaluable source for this one, recently made this interesting distinction between what a patient might reasonably or rightfully expect. Jane Brody wrote in the NY Times about the state’s Palliative Care Information Act, which Pope describes as “ basically a specialized informed consent obligation like that earlier enacted in California and more recently considered in Maryland and Arizona.”

Brody wrote: "Even knowing these facts [about palliative options], some patients are likely to choose to take advantage of anything and everything in the medical armamentarium that could conceivably grant them extra days, weeks or months of life. And such a choice is the prerogative of every terminally ill patient; the new law does not in any way deny that choice."

Pope’s distinction: “Well, the PCIA does not deny that choice. But it is hardly clear that patients have that right under New York law.”

KEVORKIAN'S LEGACY

NY Times columnist Ross Douthat on the death of Jack Kevorkian: “Fortunately, the revolution Kevorkian envisioned hasn’t yet succeeded. Despite decades of agitation, only three states allow some form of physician-assisted suicide. The Supreme Court, in a unanimous 1997 decision, declined to invent a constitutional right to die. There is no American equivalent of the kind of suicide clinics that have sprung up in Switzerland, providing painless poisons to a steady flow of people from around the globe.”

ADVANCE DIRECTIONS

The Department of Health and Human Services makes the astounding estimate of "between 65% and 76% of physicians whose patients had an (advance directive) were unaware of its existence." What might raise physician awareness of their patients’ written wishes? Pope points to an idea proposed in “The Advance Directive Registry or Lockbox: A Model Proposal and Call to Legislative Action.”in the Journal of Legislation, by Joseph Karl Grant. See Grant’s abstract at: http://bit.ly/l0OJ2C