Wills, Trusts & Estates Prof Blog

Editor: Gerry W. Beyer
Texas Tech Univ. School of Law

Thursday, September 6, 2018

Article on The Latest 'Federal Movement' in the Food and Drug Law Arena: The Federal Right-to-Try or Rather Right-to-Know and Thus Request Investigational Therapies for Individuals with a Life-Threatening Disease or Condition

PillsRoseann B. Termini recently published an Article entitled, The Latest 'Federal Movement' in the Food and Drug Law Arena: The Federal Right-to-Try or Rather Right-to-Know and Thus Request Investigational Therapies for Individuals with a Life-Threatening Disease or Condition, Elder Law eJournal (2018). Provided below is an abstract of the Article:

Does the recently enacted Federal Right-to-Try Act provide improved access for the desperately ill? Will insurance companies provide reimbursement for a patient to undergo such investigational therapies? Is the manufacturer protected in terms of lawsuits? That is, does the patient relinquish the right to bring a legal action? Will physicians comprehend the pathway and advocate for their patients? Does this new law guarantee “any novel federal right”? The national state movement regarding Right-to-Try state legislation spurred the enactment of the Federal Right-to-Try (Federal Right-to-Try Act) legislation passed in 2018. Yet, even prior to the enactment of the Federal Right-to-Try law, the United States Federal Food and Drug Administration (FDA) has had mechanisms in place for those terminally ill who do not qualify for a clinical trial.

This article provides a Federal Primer on the Investigational Drug, Biologic and Device Process, details a similar national right-to-know movement in the food and drug law arena that led to federal legislation perhaps comparable to how the Federal Right-to-Try Act was enacted and includes a discussion about the state right to try movement which conceivably led to the enactment of the Federal Right-to-Try Act. There are more queries than unambiguous answers regarding the recently enacted Federal Right-to-Try Act. The federal law in essence could prove troublesome and confusing with both the state Right-to-Try measures due to, for instance, issues of national uniformity and preemption. Further, could the recently enacted Federal Right-to-Try Act ultimately be detrimental to the patient in terms of lack of adequate safeguards and perhaps a false unrealistic sense of hope?

September 6, 2018 in Articles, Death Event Planning, Elder Law, Estate Planning - Generally, New Legislation, Science | Permalink | Comments (0)

Friday, August 24, 2018

Tranquil Strategies for Fighting Dementia in the Netherlands

DementiaThe Netherlanders have an alternative and peaceful strategy to treat dementia patients. The unorthodox treatment includes harnessing the power of relaxation, childhood memories, sensory aids, soothing music, family structure and other tools to heal, calm and nurture them instead of relying on medication, bed rests, and possible restraints. Dementia, a group of related syndromes, can be a steep decline in brain function that steals memories and personalities of the inflicted.

“The more stress is reduced, the better,” said Dr. Erik Scherder, a neuropsychologist at the Vrije Universiteit Amsterdam and one of the country’s best-known dementia care specialists. In the 1990s, the Dutch started thinking differently about how to treat the disease, moving away from a medicalized approach that simply treated clients as hospital patients.

Katja Ebben, who is the intensive care manager at Vitalis Peppelrode, a home in Eindhoven, said she had noticed that with the newer techniques, patients need less medication and fewer physical restraints. Willy Briggen, 89, lives at the Eindhoven home and is subject to outbursts due to her advanced dementia. A decade ago the staff may have medicated her to calm her, but now they roll a squat projector into her room, where it beams out calming images and plays soothing sounds.

See Christopher F. Schuetze, Look at These Unusual Strategies for Fighting Dementia, New York Times, August 22, 2018.

Special thanks to Lewis Saret (Attorney, Washington, D.C.) for bringing this article to my attention.

August 24, 2018 in Current Affairs, Disability Planning - Health Care, Elder Law, Estate Planning - Generally, Science | Permalink | Comments (0)

Thursday, August 9, 2018

You May Have Signed a Living Will, but Scary Mistakes can Happen at the ER

DNRMisunderstandings involving documents meant to guide end-of-life decision-making are “surprisingly common,” said Williams-Murphy, medical director of advance-care planning and end-of-life education for Huntsville Hospital Health System in Alabama. A new report out of Pennsylvania, treats mix-ups involving end-of-life documents as medical errors — a novel approach. Pennsylvania health-care facilities reported nearly 100 events relating to patients’ “code status” — their wish to be resuscitated or not, should their hearts stop beating and they stop breathing. In 29 cases, patients were resuscitated against their wishes. In two cases, patients weren’t resuscitated despite making it clear they wanted this to happen.

The problem, Regina Hoffman, executive director of the Pennsylvania Patient Safety Authority and co-author of the report, explained that doctors and nurses receive little if any training in understanding and interpreting living wills, DNR orders and Physician Orders for Life-Sustaining Treatment (POLST) forms.

Make sure you have ongoing discussions about your end-of-life preferences with your physician, your surrogate decision-maker, if you have one, and your family, especially when your health status changes. Without these conversations, documents can be difficult to interpret.

See Judith Graham, You May Have Signed a Living Will, but Scary Mistakes can Happen at the ER, Washington Post, August 5, 2018.

Special thanks to Naomi Cahn (Harold H. Greene Professor of Law, George Washington University School of Law) for bringing this article to my attention.

 

August 9, 2018 in Current Affairs, Elder Law, Estate Planning - Generally, Science, Technology | Permalink | Comments (0)

Tuesday, August 7, 2018

Drinking Too Much—or Not at All—May be Linked to Dementia

  BeerA long term study published August 1 in the British Medical Journal followed the drinking habits of more than 9,000 civil servants between the age of 35 and 55 years old starting in 1983 and found a link between drinking excessively or not at all may both be linked to developing dementia.

The study determined that moderate drinking was comparable to 8 standard American drinks, and those drinking more than that "the risk of dementia increases as the number of alcohol units consumed increases," according to lead author Séverine Sabia, a researcher at Inserm, the French National Institute of Health and Medical Research. If a person drank themselves into hospitalization, the likelihood increased to 400%. On a surprising note, those that completely abstained from any alcohol consumption were nearly 50% more likely than moderate drinkers to develop dementia.

The study does have one noticeable drawback - it relied on self-reported alcohol consumption, and "people have a tendency to under report."

See Devon Frye, Drinking Too Much—or Not at All—May be Linked to Dementia, Psychology Today, August 7, 2018.

 

August 7, 2018 in Current Affairs, Estate Planning - Generally, Science | Permalink | Comments (0)

Saturday, August 4, 2018

How do You Want to Die?

HeartNo one want to die too soon, but when asked, a person would want to die quickly and painlessly. Though an implantable defibrillator may extend the life of a patient with an increased risk of arrhythmia, it alleviates the "chance" of dying quickly. Instead, the patient lives longer but may end up passing away from congestive heart failure with the lungs slowly filling with fluids and can be physically agonizing.

Defibrillators offer many amazing benefits and they are highly effective. Studies have shown that they prolong life in a significant number of cardiac patients and the implantation procedure is safe. And defibrillators can, in theory, be compatible with a quick death: When a patient’s condition spirals downward, the patient can choose to deactivate the device, though rarely does a patient choose this option.

See Sandeep Jauhar, How do You Want to Die?, New York Times, July 28, 2018.

Special thanks to Lewis Saret (Attorney, Washington, D.C.) for bringing this article to my attention.

August 4, 2018 in Current Affairs, Death Event Planning, Estate Planning - Generally, Science, Technology | Permalink | Comments (0)

Monday, July 30, 2018

New Alzheimer’s Drug Slows Memory Loss in Early Trial Results

TreeFor the first time in a large clinical trial, a drug was able to both reduce the plaques in the brains of patients and slow the progression of dementia. The trial involved 856 patients from the United States, Europe and Japan with early symptoms of cognitive decline. They were diagnosed with either mild cognitive impairment or mild Alzheimer’s dementia, and all had significant accumulations of the amyloid protein that clumps into plaques in people with the disease, said Dr. Lynn Kramer, chief medical officer of Eisai, a Japan-based company that developed the drug.

Many other drugs have managed to reduce amyloid levels but they did not ease memory decline or other cognitive difficulties. In the data presented Wednesday, the highest of the five doses of the new drug — an injection every two weeks of 10 milligrams per kilogram of a patient’s weight — both reduced amyloid levels and slowed cognitive decline when compared to patients who received placebo.

See Pam Belluck, New Alzheimer’s Drug Slows Memory Loss in Early Trial Results, New York Times, July 25, 2018.

Special thanks to Lewis Saret (Attorney, Washington, D.C.) for bringing this article to my attention.

July 30, 2018 in Current Affairs, Disability Planning - Health Care, Elder Law, Estate Planning - Generally, Science, Technology | Permalink | Comments (0)

Wednesday, July 25, 2018

Augmented Reality Assists With "Freezing" Symptom

ParkinsonBioengineering students at Rice have designed an augmented reality app to help patients with Parkinson’s overcome a symptom known as “freezing”, in which the legs temporarily refuse to follow the brain’s command to lift and move forward.

https://www.linkedin.com/feed/update/urn:li:activity:6425337705885954048

Special thanks to Lewis Saret (Attorney, Washington, D.C.) for bringing this article to my attention.  

July 25, 2018 in Current Affairs, Disability Planning - Health Care, Elder Law, Estate Planning - Generally, Science, Technology | Permalink | Comments (0)

Monday, July 23, 2018

Article on Inheritance Rights for Posthumously Procreated Children: A Growing Challenge for the Law

FrozeneggsJustin d'Almaine recently published an Article entitled, Inheritance Rights for Posthumously Procreated Children: A Growing Challenge for the Law, Wills, Trusts, & Estates Law eJournal. Provided below is an abstract of the Article:

Significant advances in cryogenic technology render it possible to freeze and store human gametes. Under appropriate laboratory conditions frozen gametes can remain viable for long periods of time. In consequence, it is possible for a child to be conceived and procreated after the death of one or both parents. This raises some challenging juristic problems. Amongst these are implications for the law of inheritance. Where a valid will expressly refers to a child who will be procreated after the testator's death, the child's right to inherit will be secured. However, where a will merely refers to children as a class, or with intestate succession, it becomes uncertain whether a posthumously procreated child has a right to inherit. South African legislation governing succession, the common law and the Constitution of the Republic of South Africa, 1996 all fail to provide definitive answers. Because of this and as the numbers of posthumously procreated children are likely to increase as artificial reproduction services become more widely available, there is a need for South African legislation to clarify their inheritance rights.

July 23, 2018 in Articles, Current Affairs, Estate Administration, Estate Planning - Generally, Science, Technology, Trusts, Wills | Permalink | Comments (0)

Wednesday, July 18, 2018

Why Diagnosing Alzheimer’s Today is so Difficult—and How we can do Better

TreeBill Gates announced seven months ago that he would begin investing in Alzheimer's research and the response has been overwhelming. He has learned that the diagnosis process is "less than ideal," invasive, and experience - an initial cognitive test, then a determination if there are any other possible causes for memory loss, such as a stroke or a nutritional deficiency. If those are ruled out, a spinal tap or PET scan can be relied upon. Unfortunately many insurance policies will not reimburse for Alzheimer's exams.

The harsh truth is that currently a 100% confirmation of Alzheimer's is not currently possible until an autopsy is performed.

A point of contention is that patients are not tested for the disease until they are already starting to show signs of cognitive decline. Research suggests Alzheimer’s starts damaging the brain more than a decade before symptoms start showing. That’s probably when we need to start treating people to have the best shot at an effective drug.

See Bill Gates, Why Diagnosing Alzheimer’s Today is so Difficult—and How we can do Better, Bill Gates, July 17, 2018.

Special thanks to Lewis Saret (Attorney, Washington, D.C.) for bringing this article to my attention

July 18, 2018 in Current Affairs, Disability Planning - Health Care, Elder Law, Estate Planning - Generally, Science | Permalink | Comments (0)

Thursday, July 12, 2018

Sixth Municipality in Massachusetts to Call for Death with Dignity Legislation

CapecodOn Monday Falmouth in Massachusetts became the sixth municipality in the state to agree to pass a resolution to request the legislature to legalize allowing terminally ill patients to receive life-ending medication from their medical practitioner. Commonly known as physician-assisted suicide or Death with Dignity, the practice is legal in several United State jurisdictions including Washington, Vermont, and Colorado.

It may be an uphill battle, however. In 2012 voters narrowly defeated a referendum that would have allowed the practice, and in 2017 a medical aid in dying bill did not make it past the public health committee. Right-to-life groups and the Catholic Church are also strongly opposed to the legalization of physician-assisted suicide, fearing it will be used to contain expenditures of costly medical treatments.

There is support for Death with Dignity laws by the medical world, as the American Medical Society declined to reaffirm its opposition to the practice and the Massachusetts Medical Society officially dropped its stance against it.

See Cynthia McCormick, Falmouth Backs Death with Dignity, Cape Cod Times, July 10, 2018.

 

July 12, 2018 in Death Event Planning, Estate Planning - Generally, Religion, Science | Permalink | Comments (0)