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18Is There a Right to Futile Treatment? The Case of a Dying Patient with AIDSJournal of Clinical Ethics 1 (1): 19-23. 1990.
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10The Role of an Ethics Committee in Resolving Conflict in the Neonatal Intensive Care UnitJournal of Law, Medicine and Ethics 23 (1): 27-32. 1995.What should be the role of an institutional ethics committee in resolving conflict concerning patient care decisions in the neonatal intensive care unit? This question takes on added importance in light of recent court decisions which suggest that IEC deliberations may serve as persuasive evidence in court, of proposed state regulations that would establish an IEC as an alternative to judicial review, and of recent Joint Commission on Accreditation of Healthcare Organizations guidelines that req…Read more
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26The Role of an Ethics Committee in Resolving Conflict in the Neonatal Intensive Care UnitJournal of Law, Medicine and Ethics 23 (1): 27-32. 1995.What should be the role of an institutional ethics committee in resolving conflict concerning patient care decisions in the neonatal intensive care unit? This question takes on added importance in light of recent court decisions which suggest that IEC deliberations may serve as persuasive evidence in court, of proposed state regulations that would establish an IEC as an alternative to judicial review, and of recent Joint Commission on Accreditation of Healthcare Organizations guidelines that req…Read more
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20Should HECs conduct retrospective review of cases from their institution for educational purposes?HEC Forum 11 (3): 254-255. 1999.
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55In re Edna MF: Case law confusion in surrogate decision makingTheoretical Medicine and Bioethics 20 (1): 45-54. 1999.I review the recent case of Edna Folz, a 73 year-old woman who was suffering through the end stages of very advanced Alzheimer's dementia when her case was adjudicated by the Wisconsin Supreme Court. I consider this case as an example of how courts are increasingly misinterpreting the ethical and legal decision-making standards known as substituted judgment and best interests and thereby threatening individuals' treatment decision-making rights as developed by other courts over the past two deca…Read more
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7Health Care Providers' Liability Exposure for Inappropriate Pain ManagementJournal of Law, Medicine and Ethics 24 (4): 360-364. 1996.Recent studies have exposed the startling inadequacy of health care providers knowledge about and practice of effective pain management. For example, in one study, it was reported that 79 percent of a random sample of 454 medical-surgical inpatients experienced pain during hospitalization, and that 58 percent of patients with pain considered the pain horrible or excruciating. In another study, 67 percent of 2,415 randomly selected hospitalized patients had pain during the twenty-four hours prior…Read more
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13Health Care Providers' Liability Exposure for Inappropriate Pain ManagementJournal of Law, Medicine and Ethics 24 (4): 360-364. 1996.Recent studies have exposed the startling inadequacy of health care providers knowledge about and practice of effective pain management. For example, in one study, it was reported that 79 percent of a random sample of 454 medical-surgical inpatients experienced pain during hospitalization, and that 58 percent of patients with pain considered the pain horrible or excruciating. In another study, 67 percent of 2,415 randomly selected hospitalized patients had pain during the twenty-four hours prior…Read more
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21Wisconsin Healthcare Ethics CommitteesCambridge Quarterly of Healthcare Ethics 6 (3): 288. 1997.Over the past two decades ethics committees have proliferated in healthcare institutions across the country. Catalysts for this growth include the endorsement of ethics committees by the New Jersey Supreme Court in the Quinlan case, by the President's Commission for the Study of Ethical Problems in Medicine and Biomedical Research in its report entitled Deciding to Forgo Life Sustaining Medical Treatment, by the U.S. Department of Health and Human Services in its 1985 “Baby Doe” regulations, by …Read more
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34Managed Care, Doctors, and Patients: Focusing on Relationships, Not RightsCambridge Quarterly of Healthcare Ethics 12 (3): 300-307. 2003.For over a decade, managed care has profoundly altered how healthcare is delivered in the United States. There have been concerns that the patient-physician relationship may be undermined by various aspects of managed care, such as restrictions on physician choice, productivity requirements that limit the time physicians may spend with patients, and the use of compensation formulas that reward physicians for healthcare dollars not spent. We have previously published data on the effects of manage…Read more
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50Managed Care: Effects on the Physician-Patient RelationshipCambridge Quarterly of Healthcare Ethics 9 (1): 71-81. 2000.Over the past several years, healthcare has been profoundly altered by the growth of managed care. Because managed care integrates the financing and delivery of healthcare services, it dramatically alters the roles and relationships among providers, payers, and patients. While analysis of this change has focused on whether and how managed care can control costs, an increasingly important concern among healthcare providers and recipients is the impact of managed care on the physicianpatient relat…Read more
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16Legislative Research Bans on Human CloningCambridge Quarterly of Healthcare Ethics 12 (4): 393-400. 2003.Recently, the U.S. House of Representatives voted, for the second time in two years, to ban all human-cloning research, whether the research involves reproduction or creating cells that might be used to understand and treat disease. As I explain in this article, the proposed legislation has important implications not only for human cloning research but also for research in general
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31Everything You Always Wanted to Ask a Lawyer about Ethics CommitteesCambridge Quarterly of Healthcare Ethics 1 (1): 33. 1992.It should come as no surprise that we will get three different answers to the same question since we have three lawyers on the panel. The law is a matter of policy, and there is usually no single “right” answer to these questions. Each lawyer will come to a question from a very different perspective and bring a different approach to the answer
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12Unanswered Questions Surrounding the Patient Self–Determination ActCambridge Quarterly of Healthcare Ethics 1 (2): 117. 1992.The Patient Self-Determination Act imposes new requirements on health care providers for informing patients of their rights to make decisions concerning their medical care. The Act is intended to, and is likely to, encourage patients and residents of certain healhtcare facilities to consider their treatment preferences in advance of incapacity and, in particular, to determine the circumstances in which life-sustaining treatment will be provided to them. However, many questions concerning how hea…Read more