HealthLawProf Blog

Editor: Katharine Van Tassel
Akron Univ. School of Law

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Friday, September 15, 2006

ER Homicide

CNN.Com and other news sources report that a corner's jury found that the death of a heart attack patient who waited approximately two hours in a hospital waiting room was a homicide.  According to CNN,

Beatrice Vance, 49, died of a heart attack, but the jury at a coroner's inquest ruled Thursday that her death also was "a result of gross deviations from the standard of care that a reasonable person would have exercised in this situation."

A spokeswoman for Vista Medical Center in Waukegan, where Vance died July 29, declined to comment on the ruling. (Jury's findingsexternal link)

Vance had waited almost two hours for a doctor to see her after complaining of classic heart attack symptoms -- nausea, shortness of breath and chest pains, Deputy Coroner Robert Barrett testified.

She was seen by a triage nurse about 15 minutes after she arrived, and the nurse classified her condition as "semi-emergent," Barrett said. He said Vance's daughter twice asked nurses after that when her mother would see a doctor.

When her name was finally called, a nurse found Vance slumped unconscious in a waiting room chair without a pulse. Barrett said. She was pronounced dead shortly afterward.

Barrett said he subpoenaed records after finding discrepancies in the hospital's version of events.

It wasn't immediately clear if the ruling would lead to criminal charges. Dan Shanes, a chief of felony review for the state attorney's office, said his division needed to review the case.

I have heard some radio reports as well but not too many more details.  I haven't heard of this happening before - it is very tragic.

September 15, 2006 | Permalink | Comments (0) | TrackBack (0)

Thursday, September 14, 2006

New Disability Law Case: Obesity

Professor Sam Bagenstos at The Disability Law Blog has a great discussion of the recent 6th Circuit decision in EEOC v. Watkins Motor Lines, Inc, a case involving a worker who had been fired due to his morbid obesity.  As Professor Bagenstos explains,

"The Sixth Circuit held that the worker did not have a "disability" for purposes of the ADA, because he did not show that his obesity had a "physiological cause" and therefore qualified as a "physiological disorder." Although the EEOC had shown that the worker's weight was more than 100% greater than the norm (sufficient for a diagnosis of morbid obesity under the traditional definition), they failed to show that the weight was "the result of a physiological condition."

This decision seems to me quite confused, though it's a confusing area so I cut the court some slack. What does it mean to say that morbid obesity has a "physiological cause"? All of our behavior has some physiological cause, if only from hormones and brain activity. And there's lots of reason to believe that brain proteins that alter appetite and activity levels, not to mention genetics, are substantial contributors to morbid obesity. More broadly, every fact about our body is by definition physiological. And morbid obesity, being a condition of one's physiology, is by definition a "physiological condition.""

As a commentator notes, the court seems to be adding a personal responsibility issue into the disability law.

September 14, 2006 | Permalink | Comments (0) | TrackBack (0)

Overview of Supreme Court Term

Law.com's Howard Bashman provides a brief overview of the upcoming Supreme Court term.   It should be an interesting term.  Not too many health law items on the agenda - the federal abortion ban cases Gonzales v. Planned Parenthood and Gonzales v. Carhart appear as the most watched health law cases at this time. 

For a funny look at the upcoming term, see AbovetheLaw.com

September 14, 2006 | Permalink | Comments (0) | TrackBack (0)

Wednesday, September 13, 2006

Just for Fun - Zidane Video Clips

I don't know how many of you watched the World Cup Soccer final this summer but some of you may recall that a French player (Zidane) headed one of the Italian players in the chest late in the game and was ejected.  This website shows how individuals from various countries viewed this behavior.  I found it amusing and also a somewhat helpful teaching tool.  The website shows some of the difficulties with eyewitness testimony because it demonstrates (in a rather extreme manner) that many people watching the same incident may view and remember that incident entirely differently. 

September 13, 2006 | Permalink | Comments (0) | TrackBack (0)

New GAO Report on Health Savings Accounts

Ezra Klein provides a brief overview of some of the findings of the new General Accounting Office (GAO) report on Health Savings Accounts (HSAs), the alleged wave of the future for helping to control health care costs.  He quotes some of the key language from the report:

HSA proponents see the accounts as a way to incentivize account holders to shop carefully for health care services, but GAO did not find that to be the case in questioning members of focus groups. "Few participants researched the cost of hospital or physician services before obtaining care, although many participants researched the cost of prescription drugs," the report found.

Oops!  Perhaps we should re-think these.  The report also discusses how HSAs do not work well for individuals with chronic medical conditions who use health care providers and services on a regular basis.

September 13, 2006 | Permalink | Comments (0) | TrackBack (0)

Lateral Moves by Law Faculty

Concurring Opinions provides an updated list of lateral moves by law faculty over the past year.  Looks like lots of people were on the move.  I hope everyone is happy with their new school!

September 13, 2006 | Permalink | Comments (0) | TrackBack (0)

Monday, September 11, 2006

For Those Advising Students Looking for Judicial Clerkships

Here is a link to a new blog to help with your students with this Fall's judicial clerkship hunt:  http://lawschoolclerkship.blogspot.com/

The opening paragraph describes how the Clerkship Notification Blog works:

Welcome to the Clerkship Notification Blog for the hunting season of 2006. The goal of this blog is to provide a forum for law clerk applicants to share information regarding their clerkship applications. By using the "comments" function applicants can easily find and share information as to which judges have started calling applicants, which judges have started making offers, and which judges have completed their hiring. Posting is entirely anonymous (though you are, of course, free to sign your name).

September 11, 2006 | Permalink | Comments (0) | TrackBack (0)

Chronic Pain

PrawfsBlawg has a moving piece about chronic pain that I thought you might find interesting.  Here is a brief excerpt:

At Prawfsblawg, we've often lauded the scholarly and more informal writings of Bill Stuntz of Harvard Law School.  This week, in the New Republic, he has a strikingly more autobiographical piece describing his struggles with chronic pain stemming from an intractable back problem.  The cutline suggests Stuntz is writing a book on the topic as well.  Some of what he has to say:

    • I used to think the "chronic" part of chronic pain was the really bad part. Now I'm not so sure. Neverending pain wears you down; it's exhausting. But, on the whole, I think I'd rather have constant pain than the variable kind. . . . Pain is largely about the gap between expectation and reality: the distance between what you feel now and what your mind tells you you're supposed to feel. As reality slides downhill, expectations slide, too. Which makes reality feel less awful.
    • Something very important follows from this. Hope hurts; optimism amplifies suffering. The pain-free, healthy world is gone; this is my world now.
    • Work feels more satisfying, even though it's much harder to do. . . . Athletes have a terrific expression for this phenomenon: They say, "He left it all on the field," meaning there was nothing held back; the reserves were all spent. These days, I leave it all on the field--because there isn't any good alternative.

Stuntz's piece compels me to share some observations.  We're not normally about sharing here at Prawfsblawg, but what the hell.  I speak as someone who has had arthritis since the age of 4, who is the not-so-proud possessor of two artificial hips (implanted at the too-early age of 21), and who, alas, also suffers from some of the same back problems that Stuntz deals with.  My students are all too used to my classroom pattern of switching between brief stints of standing and longer spells in a chair at the front of the class.  (I might add that they are entirely gracious about it.).

The entire piece is well worth a read and the author has significant insights in dealing with chronic pain.   Thanks to Professor Paul Caron for sharing this article with me.

September 11, 2006 | Permalink | Comments (0) | TrackBack (0)

Chronic Pain

PrawfsBlawg has a moving piece about chronic pain that I thought you might find interesting.  Here is a brief excerpt:

At Prawfsblawg, we've often lauded the scholarly and more informal writings of Bill Stuntz of Harvard Law School.  This week, in the New Republic, he has a strikingly more autobiographical piece describing his struggles with chronic pain stemming from an intractable back problem.  The cutline suggests Stuntz is writing a book on the topic as well.  Some of what he has to say:

    • I used to think the "chronic" part of chronic pain was the really bad part. Now I'm not so sure. Neverending pain wears you down; it's exhausting. But, on the whole, I think I'd rather have constant pain than the variable kind. . . . Pain is largely about the gap between expectation and reality: the distance between what you feel now and what your mind tells you you're supposed to feel. As reality slides downhill, expectations slide, too. Which makes reality feel less awful.
    • Something very important follows from this. Hope hurts; optimism amplifies suffering. The pain-free, healthy world is gone; this is my world now.
    • Work feels more satisfying, even though it's much harder to do. . . . Athletes have a terrific expression for this phenomenon: They say, "He left it all on the field," meaning there was nothing held back; the reserves were all spent. These days, I leave it all on the field--because there isn't any good alternative.

Stuntz's piece compels me to share some observations.  We're not normally about sharing here at Prawfsblawg, but what the hell.  I speak as someone who has had arthritis since the age of 4, who is the not-so-proud possessor of two artificial hips (implanted at the too-early age of 21), and who, alas, also suffers from some of the same back problems that Stuntz deals with.  My students are all too used to my classroom pattern of switching between brief stints of standing and longer spells in a chair at the front of the class.  (I might add that they are entirely gracious about it.).

The entire piece is well worth a read and the author has significant insights in dealing with chronic pain.   

September 11, 2006 | Permalink | Comments (0) | TrackBack (0)

Saturday, September 9, 2006

Consumer-Driven Health Care

The terrific Ezra Klein has a new post on the problems with cosumer-driven health care, focusing particularly on the problem that most patients do not have the means or knowledge to evalutate accurately the health care they receive.  He writes,

Over in the Wall Street Journal, more empirical scorn is being heaped on consumer-drected health care, this time in the form of a study showing that consumers have absolutely no idea what good health care is.  Researchers from the Rand Corp., UCLA, and Department of Veteran's Affairs had 236 elderly patients in two major managed care plans rate the quality of their health care.  Satisfaction was high, with the average rating a super 8.9.

Then the researchers sat down to rate the care these same patients received.  They compared care received to care that should have been received, checking on fundamental metrics like whether a patient received aspiring within an hour of being diagnosed with acute myocardial infraction.  Scores plummeted.  Despite the high level of patient-satisfaction, the researchers gave the care a failing grade of 5.5.  More interesting, the patients who rated their care as a 10 were just as likely to be getting low-quality care as those who reported a 5.

The problem?  Patients are not qualified to evaluate good care. They're qualified to evaluate whether the doctor was nice to them, whether he explained things clearly, whether the wait time was short and the experience pleasant.  They do not know how well their care matched up to accepted standards of care, and they do not know whether the treatments they were given were comprehensive, well-targeted, or adeptly conducted.

Oops!  Read the rest of his entry and the comments - very illuminating.

September 9, 2006 | Permalink | Comments (0) | TrackBack (0)

Thursday, September 7, 2006

Disability Convention: US Unlikely to Sign

An interesting article in the New Standard reports that United States has played a large role in influencing the new Convention on the Rights of People with Disabilities but doesn't want to sign on to it.  The article states:

The United Nations has been working on the Convention on the Rights of Persons with Disabilities since December 2001, when it formed ad-hoc committees to study the issue. Five years later, UN delegates are in a final week of negotiations over provisions of the draft convention, which aims to promote respect, autonomy, non-discrimination, inclusion, accessibility and equal opportunity for people with disabilities.

"Our view is that the US actually already has in existence on the federal level, the state level and the local level a very good framework of laws and practices to assist citizens with disabilities," Paul Denig, with the US State Department, told The NewStandard, referring to the 1990 Americans with Disabilities Act (ADA). "In our view, this treaty would not add to that." . . .

Silvia Yee, staff attorney at the California-based Disability Rights Education and Defense Fund, said it is important for the US to sign the treaty to show support for the world’s 650 million people who have disabilities, many of whom currently have few rights. . . .

"Though the US refuses to sign the convention, it has been heavily involved in negotiations on many of the draft’s provisions, including end of life issues; parental decision-making regarding children; the prohibition against involuntary sterilization; and informed consent for genetic testing, medical research and scientific experimentation.

Yee said she does not believe US opposition to signing the convention has anything to do with the issue of disability rights.

"I think it’s because the US just doesn’t necessarily believe in the international treaty and rights monitoring model," she speculated. "I think it has always been very staunch about the sovereignty of the United States and not necessarily in favor of any giving up of that sovereignty in terms of recognizing international bodies."

According to the UN Secretariat Thomas Schindlmayr, only 45 countries have anti-discrimination legislation protecting disabled people. The General Assembly’s ad-hoc committee is scheduled to wrap up negotiations today.

September 7, 2006 | Permalink | Comments (0) | TrackBack (0)

Mark McClellan Resigns

Yesterday, the New York Times reported that Dr. Mark B. McClellan, announced that he will resign as  administrator for the Centers for Medicare and Medicaid Services early next month.  His announcement included a statement concerning how proud he was "to have provided prescription drug benefits to older Americans in the biggest expansion of the program since its creation 40 years ago."  The Times article demonstrates how controversial some of his decisions were.  According to the Times,

Democrats have made clear that if they win a majority in either house of Congress, they will investigate many of Dr. McClellan’s decisions. . . .

Senator Charles E. Grassley, the Iowa Republican who is chairman of the Finance Committee, said: “There were bound to be some start-up problems, and glitches continue. Dr. McClellan has worked to fix the problems. I hope that his departure doesn’t cause delays in getting snags fixed for beneficiaries and that he’ll correct all known problems before he leaves.’’

No one was named to succeed Dr. McClellan. His agency accounts for about one-fifth of the entire federal budget, spending more than $550 billion a year on health care for more than 90 million Americans.

The next administrator faces two huge political challenges. One is how to reverse increases in the number of people without health insurance and how to pay for Medicare and Medicaid, whose costs are expected to soar as millions of baby boomers age.

September 7, 2006 | Permalink | Comments (0) | TrackBack (0)

Friday, September 1, 2006

Great Health Law Prof Position

Health Law Faculty Position:

Quinnipiac University School of Law invites applications and nominations for a lateral appointment in Health Law. Candidates should have a record of outstanding scholarship and teaching, including a full-time faculty appointment at a distinguished law school, and an interest in building a health law specialty of national prominence. Salary, benefits, support for research and other special needs are negotiable and highly competitive.

Quinnipiac University School of Law's extensive health law program includes:

* A seven-year-old health law concentration for J.D. students willing to devote 15 credit-hours to health law specialty courses, written work and clinical work. Between 5 and 10% of our students graduate in the health-law concentration annually.

* The Center for Health Law & Policy, which sponsors health-related educational efforts and symposia, including a new speaker series which this year will include Professors Frances Miller from BU, Carter Snead of Notre Dame, Bryan Liang of California Western, Thomas Greaney of Saint Louis, Carol Liebman of Columbia, and Jennifer Prah Ruger of Yale School of Public Health .

* A new LL.M in Health Law, admitting its first students this year.

* A Certificate Program in Healthcare Compliance (offered jointly with Quinnipiac's School of Business). Ours is the first university-based certificate to earn accreditation from the Health Care Compliance Association.

* A JD/MBA with a health-management concentration.

* A student-edited Health Law Journal

* A Health Law Clinic, where students represent qualifying clients with disability, health-benefit, health-access and other claims.

* Numerous health-related externships with area providers, insurance companies, and pharmaceutical firms.

* An active student Law and Medicine society.

* Annual student participation in the national Health Law Moot Court competition. Last year's Quinnipiac team won "Best Brief."

Quinnipiac's health-law program is ranked 13th in the country by US News and World Report. Quinnipiac University has highly respected undergraduate and graduate programs in nursing, physician assistance, physical therapy, pathology, occupational therapy, medical laboratory sciences and health management. Our university library has an excellent collection of health-science and health-management materials.

Quinnipiac is located in Hamden, CT, about ten minutes from New Haven, and about 1.5 hours northeast of Manhattan by car or commuter rail.

Please direct inquiries and applications to Prof. Stephen Gilles, Appointments Committee Chair, Quinnipiac University School of Law, 275 Mt. Carmel Ave., Hamden CT 06518; e-mail: Stephen.Gilles@Quinnipiac.edu.

September 1, 2006 | Permalink | Comments (0) | TrackBack (0)

Upcoming Conference - Punishment

Looks like a terrific conference -

Upcoming Social Research conference:

Punishment: The U.S. Record, which I think may interest you and some of your colleagues. This is the 16th conference in the Social Research series, which is dedicated to enhancing public understanding in an engaging, multi-disciplinary discussion and is scheduled to take place at The New School in New York City on November 30-December 1, 2006. Bob Kerrey, President of The New School, is inviting U.S. Senator Barack Obama to be the keynote speaker.

We are convening this conference at a time when our nation's prison population has soared by more than 600% since the 1970s, despite a drop in crime rates. As of 2005, over two million people were imprisoned in this country: almost one in every 136 U.S. residents. Black men, who make up 6% of the U.S. population, comprise over 40% of our prison population. A black male born today has a 32% chance of spending time in prison. Eleven states do not allow ex-cons to vote. Nearly 2,800,000 American children have at least one parent in prison or jail. In this conference, we are asking: What does this mean for our democracy? Where do our concepts of punishment come from? What is the effect of our staggeringly high incarceration rate on our families, communities and the economy? To view the agenda, schedule, paper summaries and speakers' bios and to register, please visit

www.socres.org/punishment

.

Sincerely,

Roberta Sutton

Conference Coordinator

The New School for Social Research

65 Fifth Avenue, 375 New York, NY 10003

P:: (212) 229-5776 x 3121

F:: (212) 229-5476

SocRes@newschool.edu

www.socres.org

 

We have invited speakers from many disciplines to discuss the historical and theological roots of punishment as well as current issues in the U.S. today, which will allow us to better understand the consequences of the current practice of punishment and search for viable alternatives to the carceral state in which we now live. (Please note that as an added attraction, the Metropolitan Museum of Art will offer a guided tour of its collection focused on artistic representations of punishment in collaboration with the conference.)

Because I believe that this conference may be of great interest to you and many of your colleagues, I would be extremely grateful if you would help us get word to them about it so that they might attend.

September 1, 2006 | Permalink | Comments (0) | TrackBack (0)