Elder Law Prof Blog

Assessment of Older Adults with Diminished Capacity: A Handbook for Lawyers

The American Bar Association (ABA) Commission has reissued its popular handbook, Assessment of Older Adults with Diminished Capacity: A Handbook for Lawyers. The book offers attorneys a conceptual framework and a practical system for addressing problems of client capacity, in some cases with help from a clinician. This handbook is especially helpful for lawyers who are troubled by clients who may have subtle decisional problems and questionable judgments.

The cost of the handbook is $25.00. To order, email your request to the ABA Commission at abaaging@abanet.org or call (202) 662-8690.

Conference on legal and medical issues with capacity

SWAP-C GEC: South, West, and Panhandle Consortium Geriatric Education
Center at

            The University of Texas Health Science Center at San Antonio
            2007 Medico~Legal Issues in Aging "Competence and Capacity"
            San Antonio, TX
            September 28, 2007

*    Register for the Conference Now!

Legal and Medical issues with capacity--upcoming conference

The University of Texas Health Science Center at San Antonio
2007 Medico~Legal Issues in Aging "Competence and Capacity"
San Antonio, TX
September 28, 2007

Each year, the Medico~Legal Issues in Aging Conference seeks to create a
learning environment that is exciting and energetic! Our staff and
planning committee spend countless hours developing a stellar program.
We have begun to plan for this year's program and have a very exciting
agenda planned. The primary goal of this Medico~Legal educational
program is to increase the knowledge and expertise of today's and
tomorrow's legal and health care professionals in the critical
medico~legal and ethical issues surrounding care of the elderly
population.  It is our hope that this interdisciplinary group will come
together to collaborate on how we can better improve the lives this
population.

*     Register for the Conference Now!

Kidney reality show is a (cruel) hoax

A Dutch TV contest which purported to show a dying woman choose a patient to receive her kidneys was a hoax.The "donor" in the show was in fact an actress - though the three people vying for an organ were real patients in need of a kidney transplant.  The three knew that The Big Donor Show, which aired on Friday, was not real. The producers say it was made to highlight the shortage of Dutch donors.  Before the hoax was revealed, the show had attracted widespread criticism.  "We are not giving away a kidney here, that is going too far even for us," presenter Patrick Lodiers said at the moment when the fake donor was apparently about to reveal her choice of patient.

Source:  BBC News, http://news.bbc.co.uk/2/hi/entertainment/6714063.stm

Provacative?  Outrageous?  Funny?  What do you think?  --Ed.

Baum lecturer says organs for sale is A-OK

The 2007 Ann F. Baum Memorial Elder Law Lecture will be presented on Monday, March 5 at 12:30 P.M. in the Max Rowe Auditorium at the University of Illinois by Dr. Sally L. Satel, resident scholar at the American Enterprise Institute in Washington, D.C. on “When Altruism Isn't Enough: The Worsening Organ Shortage, What It Means for Seniors, and What To Do About It.”

Details
 

 

Kidneys for sale--a million bucks OBO

The 2007 Ann F. Baum Memorial Elder Law Lecture will be presented on Monday, March 5 at 12:30 P.M. in the Auditorium by Dr. Sally L. Satel, resident scholar at the American Enterprise Institute in Washington, D.C. on “When Altruism Isn't Enough: The Worsening Organ Shortage, What It Means for Seniors, and What To Do About It.”

Dr. Satel’s thesis is that organ donors, whether they are living or deceased, should be compensated to increase the supply of transplantable organs available. She will examine the specific issue of renal failure as a major problem affecting older people and how donated kidneys can ensure better outcomes for the affected elderly compared to dialysis. She will also consider implications for Medicare, which funds the very costly end stage renal disease program. Finally, she will evaluate current efforts to restructure the allocation system of donated kidneys that discriminates against older potential recipients on the basis of age.

NAELA seeks ethics committee members

 

Are you a NAELA member who is an Institutional Ethics Committee member (at a hospital or similar facility?  Have you identified yourself to the NAELA Health Care SIG???

If not, please notify the NAELA Health Care Special Interest Group of your affiliation by e-mail to Anabel Gray, SIG Coordinator at agray@naela.com.

 

The Health Care SIG hopes to offer an opportunity for discussion of Ethics Committee issues and resolutions for those interested on the following proposed topics: 1) Pharmaceutical company relationships with staff, 2) Committee lobbying activity, 3) Adoption of MOLST/POLST and results, 4) Policy concerning family/staff translators for non-English speaking patients, and 5) Medical Futility Policies.

Current NAELA members registered with the Health Care SIG who serve on an Ethics Committees for a Health Care Provider are: Gina M. Barry; William C. Beyers, CELA; Fay Blix, CELA; Mary Z. Ceridan; Robert H. Chesley; Nancy Catalini Chew; V. Anne Edenfield; Myrna Fawcett; Daniel P. Kapsak; Doris E. Hawks; Jim Higgins; Lee M. Holmes, CELA; Ed Long; Joan Nelson Hook; Keith P. Huffman; Hurme Sally ; James A. Jaeger, CELA; Natalie J. Kaplan; Daniel P. Kapsak; Jane E. Lokken; Colleen P. MacLean, CELA; Kate Mewhinney, CELA; Peggy O'Reilly; Carole Spainhour; Emily S. Starr, CELA; Barbara A. Venesy; Dennis S. Voorhees, CELA

Notre Dame Journal of Law, Ethics & Public Policy seeks aging-related articles

The Editorial Board of the Notre Dame Journal of Law, Ethics &
Public Policy invites you to submit an article, essay, or speech for
review and possible publication in our issue on “Aging America,” to be
published in Spring 2007. We seek to explore a wide variety of topics
related to this issue’'s theme, including social security, health care,
end of life concerns, employment discrimination, international
migration, and the influence and role of religion in elder care.  We
will consider submissions related to all legal, ethical, religious, and
policy-oriented aspects of this symposium topic.

     The Journal examines public policy questions within the framework
of the Judeo-Christian intellectual, religious, and moral tradition.
Past contributors include President George W. Bush, President Ronald
Reagan, Justice William Brennan, U.N. Secretary-General Kofi Annan,
House Speaker J. Dennis Hastert, Senator Orrin Hatch, Judge
John Noonan, Judge Richard Posner,
His Eminence Francis Cardinal George, Governor Mario Cuomo, Mayor
Rudolph Giuliani, and Professor John Finnis, among others.

     The Journal devotes each issue to a single theme of public
concern, thus permitting a more comprehensive analysis. Recognized
across the nation, the Journal has been cited in nearly 2000 journal
articles and by almost thirty state and federal courts, including the
United States Supreme Court.

     If you are interested in submitting a piece for possible
publication in our Aging America” volume, please e-mail

Mary Komperda
Solicitation Editor
Notre Dame Journal of Law, Ethics, & Public Policy
komperda.1@nd.edu

for more specific details regarding deadlines and
draft guidelines.

Here's how they voted...

                                                                                                               

	Yeas	Nays	PRES	NV
Republican	216	13		2
Democratic		200		1
Independent		1
TOTALS	216	214		3

---- YEAS    216 ---
               

Aderholt Akin Alexander Bachus Baker Barrett       (SC) Bartlett (MD) Barton       (TX) Bass Beauprez Biggert Bilirakis Bishop       (UT) Blackburn Blunt Boehlert Boehner Bonilla Bonner Bono Boozman Boustany Bradley       (NH) Brady (TX) Brown (SC) Brown-Waite,       Ginny Burgess Burton (IN) Buyer Calvert Camp       (MI) Campbell       (CA) Cannon Cantor Capito Carter Castle Chabot Chocola Coble Cole       (OK) Conaway Crenshaw Cubin Culberson Davis (KY) Davis,       Jo Ann Davis, Tom Deal (GA) DeLay Dent Diaz-Balart,       L. Diaz-Balart,       M. Doolittle Drake Dreier Duncan Ehlers Emerson English       (PA) Everett Feeney Ferguson Fitzpatrick       (PA) Flake Foley Forbes Fortenberry Fossella Foxx Franks       (AZ) Frelinghuysen

Gallegly Garrett       (NJ) Gibbons Gilchrest Gillmor Gingrey Gohmert Goode Goodlatte Granger Graves Green       (WI) Gutknecht Hall Harris Hart Hastert Hastings       (WA) Hayes Hayworth Hefley Hensarling Herger Hobson Hoekstra Hostettler Hulshof Hunter Hyde Inglis       (SC) Issa Jenkins Jindal Johnson (CT) Johnson,       Sam Keller Kelly Kennedy (MN) King (IA) King       (NY) Kingston Kirk Kline Knollenberg Kolbe Kuhl       (NY) LaHood Latham Lewis (CA) Lewis       (KY) Linder LoBiondo Lucas Lungren, Daniel       E. Mack Manzullo Marchant McCaul       (TX) McCotter McCrery McHenry McKeon McMorris Mica Miller       (FL) Miller (MI) Moran       (KS) Murphy Musgrave Myrick Neugebauer Northup

Norwood Nunes Nussle Osborne Otter Oxley Pearce Pence Peterson       (PA) Petri Pickering Pitts Platts Poe Pombo Porter Price       (GA) Pryce       (OH) Putnam Radanovich Regula Rehberg Reichert Renzi Reynolds Rogers       (AL) Rogers (KY) Rogers       (MI) Rohrabacher Ros-Lehtinen Royce Ryan (WI) Ryun       (KS) Saxton Schmidt Schwarz       (MI) Sensenbrenner Sessions Shadegg Shaw Shays Sherwood Shimkus Shuster Simpson Smith       (TX) Sodrel Souder Stearns Sullivan Tancredo Taylor       (NC) Terry Thomas Thornberry Tiahrt Tiberi Turner Upton Walden       (OR) Walsh Wamp Weldon (FL) Weldon       (PA) Weller Westmoreland Whitfield Wicker Wilson       (SC) Wolf Young (AK) Young (FL)

---- NAYS    214 ---
               

Abercrombie Ackerman Allen Andrews Baca Baird Baldwin Barrow Bean Becerra Berkley Berman Berry Bishop       (GA) Bishop       (NY) Boren Boswell Boucher Boyd Brady       (PA) Brown (OH) Brown,       Corrine Butterfield Capps Capuano Cardin Cardoza Carnahan Carson Case Chandler Clay Cleaver Clyburn Conyers Cooper Costa Costello Cramer Crowley Cuellar Cummings Davis       (AL) Davis (CA) Davis (FL) Davis       (IL) Davis       (TN) DeFazio DeGette Delahunt DeLauro Dicks Dingell Doggett Doyle Edwards Emanuel Engel Eshoo Etheridge Evans Farr Fattah Filner Ford Frank       (MA) Gerlach Gonzalez Gordon Green,       Al Green, Gene Grijalva

Gutierrez Harman Hastings       (FL) Herseth Higgins Hinchey Hinojosa Holden Holt Honda Hooley Hoyer Inslee Israel Jackson       (IL) Jackson-Lee (TX) Jefferson Johnson       (IL) Johnson, E. B. Jones (NC) Jones       (OH) Kanjorski Kaptur Kennedy       (RI) Kildee Kilpatrick       (MI) Kind Kucinich Langevin Lantos Larsen       (WA) Larson       (CT) LaTourette Leach Lee Levin Lewis       (GA) Lipinski Lofgren,       Zoe Lowey Lynch Maloney Markey Marshall Matheson Matsui McCarthy McCollum       (MN) McDermott McGovern McHugh McIntyre McKinney McNulty Meehan Meek       (FL) Meeks       (NY) Melancon Michaud Millender-McDonald Miller       (NC) Miller, George Mollohan Moore       (KS) Moore (WI) Moran       (VA) Murtha Nadler Napolitano Neal       (MA) Ney Oberstar

Obey Olver Ortiz Owens Pallone Pascrell Pastor Paul Payne Pelosi Peterson       (MN) Pomeroy Price       (NC) Rahall Ramstad Rangel Reyes Ross Rothman Roybal-Allard Ruppersberger Rush Ryan       (OH) Sabo Salazar Sánchez, Linda       T. Sanchez,       Loretta Sanders Schakowsky Schiff Schwartz       (PA) Scott (GA) Scott       (VA) Serrano Sherman Simmons Skelton Slaughter Smith       (NJ) Smith       (WA) Snyder Solis Spratt Stark Strickland Stupak Sweeney Tanner Tauscher Taylor       (MS) Thompson (CA) Thompson       (MS) Tierney Towns Udall       (CO) Udall (NM) Van       Hollen Velázquez Visclosky Wasserman       Schultz Waters Watson Watt Waxman Weiner Wexler Wilson       (NM) Woolsey Wu Wynn

---- NOT VOTING    3 ---
               

Blumenauer

Istook

Miller, Gary

Ed:  Res ipsa loquitur...

Health Care Rationing: Do the poor deserve medical care?

From the New York times (Business Section!)

Do the poor deserve life support?" asks the economist Steven E. Landsburg in an article published under that title in Slate this month (www.slate.com/id/2133518/?nav=fo). The subtitle says: "A woman who couldn't pay her bills is unplugged from her ventilator and dies. Is this wrong?" Mr. Landsburg invokes "economic considerations" to suggest that the answer is "no."

Many commentators have attacked his argument as morally preposterous. Well, yes. But it is also economically preposterous. The two judgments are related. But before an attempt at explaining why, here are some details of the case, from the Slate article and the Dallas-Fort Worth television station WFAA:

The patient  was Tirhas Habtegiris, a 27-year-old legal immigrant being kept alive by a ventilator as she lay dying of cancer last month in the Baylor Regional Medical Center in Plano, Tex. Physicians offered no prospect for her recovery. She was hoping, however, to hang on until her East African mother could reach her bedside.

Ms. Habtegiris had little money and no health insurance. On Dec. 1, hospital authorities notified her brother that unless another hospital could be found to treat his sister, Baylor would be forced to discontinue care after 10 days. But even with Baylor's assistance, the family was unable to find a willing hospital. True to its word, Baylor disconnected her ventilator on Dec. 12, invoking a law signed in 1999 by George W. Bush, then governor of Texas. The law relieved doctors of an obligation to provide life-sustaining treatment 10 days after having provided formal notice that such treatment was found to be medically "inappropriate."

Read the rest.  And then ponder whether we in the US really do have "the best heatlh care system in the world."

Elderly, blind inmate to be executed in CA next week

KGO-TV reports that "there will be no reprieve for the oldest inmate on California's Death Row. Clarence Ray Allen is still scheduled to die at San Quentin in one week. The state supreme court rejected Allen's request to stop the execution. He claims it would be cruel and unusual punishment to kill a 75-year-old blind man.

Allen's attorneys say they'll go to the U.S. Supreme Court next.

Allen is scheduled to be executed next Tuesday morning for masterminding three murders in Fresno."

Get the story here.

Then take a look at the court's records on inmate Allen.

Mayo Clinic MCE: Geriatric Ethics

The Mayo Clinic will hold a three-day MCE program on geriatric ethics Feb. 8-10.  Here's a sample of the programs, from just the first day:

7:30 a.m. Registration and Continental Breakfast
8:15 a.m. Welcome/Introduction to Audience Response System
Course Directors
8:30 a.m. The Challenges of Aging: The Context of Geriatric Ethics
Paul S. Mueller,M.D.
9:15 a.m. The Challenge of Disposable Elders: The Devaluing of Wisdom
in Contemporary American Culture
C. Christopher Hook, M.D.
10:00 a.m. Refreshment Break
10:30 a.m. The Challenge of an Aging Population: Justice in Geriatric Ethics
Kevin C. Fleming, M.D.
Noon Refreshment Break/Box Lunch
12:30 p.m. The Challenge of Preserving Autonomy When Facing Death:
Assisted Suicide and Euthanasia
Robert D. Orr,M.D.
1:30 p.m. The Challenge of Feeding and Caring: Ethical Dilemmas Related
to Artificial Hydration and Nutrition and Other Life-Sustaining
Treatments
Michael P. Bannon, M.D.
3:00 p.m. Refreshment Break
3:30 p.m. The Challenge of Helping and Not Harming: The Rule of Double
Effect Palliative Care
Dan Sulmasy,M.D.
8:15 a.m. Welcome/Introduction to Audience Response System
Course Directors
8:30 a.m. The Challenges of Aging: The Context of Geriatric Ethics
Paul S. Mueller,M.D.
9:15 a.m. The Challenge of Disposable Elders: The Devaluing of Wisdom
in Contemporary American Culture
C. Christopher Hook, M.D.
10:00 a.m. Refreshment Break
10:30 a.m. The Challenge of an Aging Population: Justice in Geriatric Ethics
Kevin C. Fleming, M.D.
Noon Refreshment Break/Box Lunch
12:30 p.m. The Challenge of Preserving Autonomy When Facing Death:
Assisted Suicide and Euthanasia
Robert D. Orr,M.D.
1:30 p.m. The Challenge of Feeding and Caring: Ethical Dilemmas Related
to Artificial Hydration and Nutrition and Other Life-Sustaining
Treatments
Michael P. Bannon, M.D.
3:00 p.m. Refreshment Break
3:30 p.m. The Challenge of Helping and Not Harming: The Rule of Double
Effect Palliative Care
Dan Sulmasy,M.D.

Details and registration information are available at http://www.mayo.edu/pmts/mc4000-mc4099/mc4077-01.pdf

Elderly criminals sell pain pills to buy food

Dottie Neeley, 87, was fingerprinted, photographed and thrown in jail, imprisoned as much by the tubing from her oxygen tank as by the concrete and steel around her.

The woman - who spent two days in jail after her arrest last December - is among a growing number of Kentucky senior citizens charged in a crackdown on a crime authorities say is rampant in Appalachia: Elderly people are reselling their painkillers and other medications to addicts.

"When a person is on Social Security, drawing $500 a month, and they can sell their pain pills for $10 apiece, they'll take half of them for themselves and sell the other half to pay their electric bills or buy groceries," Floyd County jailer Roger Webb said.

Since April 2004, Operation UNITE, a Kentucky anti-drug task force crated largely in response to rampant abuse of the powerful and sometimes lethal painkiller OxyContin, has charged more than 40 people 60 or older with selling primarily prescription drugs in the mountains.

"It used to be a rare occasion to have an elderly inmate," Webb said. "Five years ago it was a rarity."

Read more in the Seattle Post-Intelligencer.

Ed:  Hmmm.  What's criminal:  an 87 year old selling her medications to buy food, or a system that doesn't ensure than an 87 year old can have her drugs and eat food too?

Eleven Minnesota Grandmas Attempt to Enlist In US Army

From WCCO in Minneapolis:

Eleven women, all grandmothers, attempted to enlist at the Army Recruiting Center near the University of Minnesota Tuesday.

The longtime peace activists said they wanted to replace young soldiers serving in Iraq.

"It's a bloody war, it's an immoral war, it's an evil war," Mary Lou Ott said. "We want it to come to a stop, and we have to find creative ways to do that."

A recruiter told the women the Army would not accept people older than 35. Police were called after the women sat down in protest.

"We decided that by allowing them to actually fill out the actual paperwork, that that would speed along the process," Army Capt. Valent Bernat said.

"We allowed them to fill out the application, and we will submit that up, which I expect will be rejected for the fact that they don't meet our requirement," he said.

Go, grannies, go. 

There have been 2,327 coalition deaths: 2,130 Americans, one Australian, 98 Britons, 13 Bulgarians, two Danes, two Dutch, two Estonians, one Hungarian, 26 Italians, one Kazakh, one Latvian, 17 Poles, one Salvadoran, three Slovaks, 11 Spaniards, two Thai, and 18 Ukrainians in the war in Iraq as of December 6, 2005. 

Not elder law: regular blog reader questions turtle link to Kansas School Board science standards

A regular reader of Elder Law Prof Blog has very politely requested (via email) that I do not use this blog "as a a stage to make disparaging remarks directed to those persons who don't share your world view" .  The writer objected to my link from the story on Harriet the turtle (who was actually handled by Charles Darwin) to the Kansas School Board's recent mandate that science teachers in Kansas must include the theory of "intelligent design" in its high school science curriculum.  Mindful as I am that this blog is supposed to be about elder law, I'd like to post my response to this reader:

Thank you for your comments.  I know better than to argue religion with anyone.  It is my blog, however, and I have used it from the very first day as a vehicle to express my world view on everything from poverty to greed to the cost of the war in Iraq.  At any rate, as you may or may not know, I have lived most of my life in Kansas, and I care very much about what its children (including my son, who is in high school there) must learn in school.  As I am sure you know, the Kansas School Board is led by a fundamentalist Christian who has no experience either as an educator or a scientist.  "Intelligent design" is a belief system with as much legitimacy as any other belief system grounded in "faith". It is not a science.  The imposition on science teachers of educational standards that are based on a particular religious viewpoint will likely cost Kansas some of its best educators; in addition, newly graduating teachers are indicating their intention to leave the state rather than teach as a legitimate "science" an idea that is creationism masked in a different name.  I have no problem with teaching "intelligent design" (or the creation myths of deism, theism, Hinduism, the ancient Greeks, or Scott Adams) in a religion or philiosophy class.  I do object to requiring science teachers to do so in science classes.

I believe the efforts of those who consider themselves to be religious persons are better directed towards ending hunger and poverty, assuring adequate health care for all, and preventing discrimination against persons who are different in some way from themselves.  This is what Jesus imagined for his followers and taught that they should do; I rather doubt he cared at all about the content of high school science classes.  Imagine what could be accomplished if the energy that has been spent on getting intelligent design theory into the classroom had been instead directed towards assuring that impoverished children have an adequate breakfast.

And with that, I'll go back to blogging on pension crises around the world, the coming national implosion in health care financing, and the scary rise in elder abuse and exploitation being reported from as far away as Japan, China, and India.

Prof. Mewhinney (Wake Forest) quoted on ethical issues

Prof. Kate Mewhinney of Wake Forest, who directs the Elder Law Clinic , was quoted today in an article in the Winston-Salem Journal  about the need for adult children and their aging parents to communicate about financial and health issues.

Some adult children dominate their parents' affairs, creating an ethical issue.

Kate Mewhinney of Wake Forest University's Elder Law Clinic said that adult children have approached the clinic, without their parents, seeking a power of attorney.

"We have a policy of saying 'We need to meet with your parents first," Mewhinney said. "Part of the dynamic is that professionals integrate the family, but not let the family take over."

Recognizing, and reckoning with, such roadblocks can be tough, but families can take some steps to jump-start a financial dialogue.

Read the full story.

Mandatory health insurance--let's cut out those free riders!!

Today in the Boston Herald,

Gov. Mitt Romney doesn't just want to make health insurance universal. He wants to make it compulsory.

In an opinion piece published in today's Herald, the possible presidential contender pushes the ball way upfield in the healthcare debate by calling ``for a personal responsibility principle'' in health insurance.

``Everyone must either become insured or maintain an adequate savings account to cover their medical expenses,'' Romney writes.

The argument: that would cut out free-riders who use today's system without paying for it. ``We cannot expect some citizens to pay for others who can afford to pay some or all of their own way,'' he writes.

Read the rest of the editorial.

I wonder if the Governor has read this article by the National Center for Policy Analysis, which concludes:

Realistically, the federal government cannot require the purchase of health insurance and leave insurers, providers and state legislators free to increase the price without limit. Mandating health insurance is an open invitation to federal regulation of the entire health care system.

Related information:

    --the average cost of health insurance premiums for a family of four, 2004 (including COBRA portion of the premium):  $9,950 (up 11% from previous year)
    --the average inflation adjusted income of a family of four, 2003:  $43,318 (cumulative decline of 3.25% since 2001)
    --average annual health insurance premium, individual (including COBRA portion):  $3,695
    --annual income of a full time day care center employee, 2003:  $7.18/hour ($14,360/yr)
    --average annual increase in cost of health insurance, 1996-2004:  8.2%
   
Because the more you know...
See also Uninsured in America:  Life and Death in the Land of Opportunity

 

This just in....

E-mail communications between lawyer and client are protected by the attorney client privilege.  But it's always best to cover your bases. We like elder law attorney John Payne's confidentiality notice and disclaimer:

CONFIDENTIALITY NOTICE:
This electronic transmission may contain information vital to national
security, subject to the attorney-client privilege, in violation of the
privilege against self-incrimination, personally embarrassing to the
President or other high officials, or simply Very Imporatant.  The
within electronic transmission, whether actually transmitted
electronically or printed using teletype, dot-matrix, thermofax,
inkjet, laser, or quill-and-paper copying from the monitor or other
method of display, without regard to whether the display is CGA, EGA,
IGA, VGA, Super-VGA, or XGA, and without regard to whether the monitor
is monochrome or color, CRT, LCD, plasma, or a candle behind a stencil,
or manually conveyed, mailed, FedExed, UPSed, Airborned, Suborned,
Borned-Again, or shot across the room with a rubber band (hereinbelow
referred to as an email) and all information contained herein is
subject to absolute privilege and is confidential and is intended to be
read or used by no one, including the individuals or entities
identified in the communication "To"and "Copy" addresses.  Whether or
not you are not the intended recipient, or an employee or agent
responsible for delivering it to the intended recipient, or an innocent
bystander (assuming that such an entity exists) you are hereby
forbidden to read any of the forgoing and are ordered, on pain of
death, to forget everything you have read, to immediately burn any
hardcopy reproduction of this email and ingest the ashes, and to
hard-format all drives on the receiving machine or network, forthwith.
You are also ordered to immediately transmit a lethal virus to the ISP
server from which this communication eminated in order to prevent any
further dissemination.  You are ordered not to read, save, print,
distribute or copy this communication in any way.  You have received
this communication in error.  If you think you are the correct
recipient, please notify us immediately by telephone at 313 563 4900,
or by carrier pigeon, then delete the original communication from your
system and destroy any printed copies that may have been made, just in
case you are, in fact, not the correct recipient.  The person or entity
listed in the "From" address rarely types an email address--or anything
else--correctly, so it is extremely unlikely that this email is
anything other than a huge mistake, for which the person or entity
listed in the "From" address offers his, her, or its abject apology,
but denies any legal liability, and in fact denies actually having
transmitted, sent, mailed, or otherwise conveyed anything.
Furthermore, the person or entity listed in the "From" address
disclaims any and all liability for any injury arising out of or from
any statement or information contained in this email. The reader agrees
to release the person or entity listed in the "From" address and anyone
who might be responsible for his debts, from any action or claim, of
whatever nature, arising from the transmission or conveyance of this
email--which transmission or conveyance is expressly denied.  This
release shall be binding on the reader and anyone who might claim
through the reader or on the reader's behalf.
This is a full release of every sort of liability, whether the reader
knows that there is potential liability or not.  The reader expressly
waives any law providing that releases only apply to claims that are
known to the person executing the release.

DISCLAIMER:
The above legal advice is conveyed and warranted to be free of all
claims and encumbrances and is guaranteed to be worth the price paid
for it.  This express warranty is offered in lieu of all implied
warranties and the reader specifically waives any implied warranty of
merchantability or fitness for a particular purpose.  The author
explicitly reserves the right to eat any word or words above, with or
without just cause and with or without condiments.  This is a work of
fiction and any resemblance to any person, living, dead or unborn, or
to any actual legal principle, is not only unintended, but probably a
mistake.  Readers are advised to consult competent legal counsel before
acting in reliance on any portion of the above, including any
disclaimer expressed or implied.  Readers are further warned that the
only difference between a Boy Scout  troop and the bar associations of
most states is that the Boy Scout troop has adult supervision.
Therefore the accuracy and value of the advice of competent legal
counsel other than the author are specifically included in this
disclaimer of all warranties.  The act of reading this post, however
odious or unpleasant, shall not be deemed detrimental reliance giving
rise to a contract requiring the author to give fair consideration by
writing something sensible.  This disclaimer should be read before
anything above and the reader expressly admits having read and fully
understood this disclaimer before reading any of the above drivel.

Used with permission, of course.

Language Line Services

Serving the needs of older clients who are ethnically and/or culturally diverse sometimes requires the services of an interpreter.  For obvious reasons, relying on family members of the client is not the best option, nor usually an ethical choice.  Language Line Services provides a means to communicate with a client who does not speak a language in which her attorney is fluent.  The telephone based service can be expensive, but interpretation may be necessary ethically to provide the best possible legal representation to such a client. 150 languages are covered by Language Line. More information is available at the company's website.