Wills, Trusts & Estates Prof Blog

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

Monday, December 10, 2018

Cancer and Marital Status: Singles may get Less Aggressive Treatment than Married People

PillsThough you may have heard that married adults are more likely to survive cancer than singles, there is an aspect of that that has yet to make headlines: patients with spouses are more likely to get surgery or radiotherapy treatment.

When determining treatment, patients are often asked if they have adult children or spouses to help them cope and manage the side effects. A review of 59 studies based on the Surveillance, Epidemiology, and End Results Program (SEER), maintained by the National Cancer Institute, covering over 7.3 patients with 28 different forms of cancer showed reported significant differences in treatment rates between married and unmarried patients.

Unmarried patients were more likely to refuse, but the proportion was small. Of 278,015 unmarried patients whose physicians recommended surgery, 1,441 refused. For radiation, it was 1,055 out of 79,303. Conspicuously absent from these studies is any analysis of the physician's role in recommending treatment.

Psychiatrist Jonathan Metzl, author of "Prozac on the Couch," says doctors view stereotyping "as bad, something we're supposed to eliminate." But judgements are inherent to human nature, and even doctors are humans. "Frame the discussion in terms of what the patient actually needs, rather than focusing on whether it's provided by people in specific roles," says Susan Brown, co-director of the National Center for Family & Marriage Research. "Our whole system is built around traditional family roles, and that doesn't work for many people."

See Joan DelFattore, Cancer and Marital Status: Singles may get Less Aggressive Treatment than Married People, Chicago Tribune, December 3, 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.

December 10, 2018 in Current Affairs, Disability Planning - Health Care, Elder Law, Estate Planning - Generally, Science | Permalink | Comments (0)

Friday, December 7, 2018

The Cremated Remains of 100 People Have Been Launched into Space on a SpaceX Rocket

ElysiumThe cremated remained of 100 individuals were launched into space in a memorial satellite by the company Elysium Space. Based out if San Francisco, the company placed samples of each person's remains on the SpaceX Falcon 9 rocket for $2,500 each.

The remains of average citizens are joined by veterans and other aerospace enthusiasts who believed their loved ones would enjoy being "within the poetry of the starry sky," Elysium Spaces said in an emailed statement. The ashes, each in an individual capsule, were placed in a 4-inch square satellite called a cubeseat, which will orbit the Earth for 4 years before it inevitably falls back, according to Elysium Space Founder and CEO Thomas Civeit.  Sixty-four small satellites from thirty-four different companies were aboard the rocket, part of a rideshare mission organized by Spaceflight.

Families will be able to track the process of the satellite as it orbits the planet, knowing that their loved ones is above them in the stars.

See Dakin Andone, The Cremated Remains of 100 People Have Been Launched into Space on a SpaceX Rocket, CNN, December 3, 2018.

December 7, 2018 in Current Events, Death Event Planning, Estate Planning - Generally, Science, Technology | Permalink | Comments (0)

Thursday, December 6, 2018

Assisted Suicide for Alzheimer’s Patients Raises Incredibly Difficult Issues

HippocraticPhysician assisted suicide was thrust into the public eye when a 104-year-old Australian scientist David Goodall decided to end his life medically. He did not have any serious or terminal illnesses. He just believed he was old, and did not want to have his abilities continue to diminish and end up in a nursing home. Because assisted suicide is not legal in Australia, he had to travel to Switzerland. He adamantly told the press that he "wanted to die."

Seven jurisdictions in the United States provide for physician assisted suicide: California, Colorado, the District of Columbia, Hawaii, Montana (with a court decision), Vermont and Washington state. Put there are built in stipulations and limits on the procedure, including: a condition that is terminal, meaning the patient has six months or less to live, restrictions on what type of doctor can write the prescription, waiting periods, different levels and forms of consent by the patient, and a showing that the patient is mentally competent.

Patients with Alzheimer's have issues with many of the restrictions. The disease can take years to kill someone, so when a person is diagnosed with Alzheimer's it is not considered a terminal illness. But the disease breaks down a person's identity to the point where they are a shadow of who they were, and many people want to end their lives before the deterioration is a burden. But by the time the erosion and disease is considered terminal, Alzheimer's patients will have lost their mental capacity to reason and thus will be barred from requesting assisted suicide. They will no longer be of sound mind.

An advanced directive may be a solution to this problem, stating the individual’s wishes before the person is stricken with Alzheimer’s disease. This would similar to a DNR or refusal of aggressive medical interventions. Also known as a living will, it is a  written statement of a person’s desires regarding medical treatment in cases where he or she is unable to give informed consent.

See Josh Bloom & Henry I. Miller, Assisted Suicide for Alzheimer’s Patients Raises Incredibly Difficult Issues, Fox News, December 2, 2018.

December 6, 2018 in Death Event Planning, Estate Planning - Generally, Science, Travel, Wills | Permalink | Comments (0)

Monday, October 29, 2018

This AI Startup Generates Legal Papers Without Lawyers, and Suggests a Ruling

AiAn artificial intelligence application (app) developed by Ignacio Raffa, a startup founder from Buenos Aires, can now draft a ruling on a non-complex case in seconds, going so far as recommending a ruling to the judge. The app was developed in collaboration with the local district attorney's office.

The app, Prometea, is being used for stuff like taxi license disputes, not murder trials, but it’s a significant automation that is beneficial to the city's overworked justice system. The Buenos Aires office says its 15 lawyers can now clear what used to be six months’ worth of cases in just six weeks. It is not meant to be used for intricate cases. “It can help legal systems around the world,” says Asha Aravindakshan, a Sloan Fellow at MIT who saw a demo of the app this summer. “Everyone has a backlog.”

Raffa trained the app using the DA office’s digital library of some 300,000 scanned court documents from 2016 and 2017 that included 2,000 rulings. So far, judges have approved 33 of its 33 suggested rulings, and it’s being used in at least 84 other pending cases. “It’s not replacing humans,” says Ezequiel González, a professor at the University of Oxford who hosted a demonstration of the app in May. “It simply comes to the rescue of judges that are buried in massive dockets.”

See Patrick Gillespie, This AI Startup Generates Legal Papers Without Lawyers, and Suggests a Ruling, Bloomberg, October 26, 2018.

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

October 29, 2018 in Current Affairs, Estate Planning - Generally, Science, Technology | Permalink | Comments (0)

Friday, October 26, 2018

CLE on Cybersecurity Issues for Planners and Their Clients

CLEThe American Bar Association is holding a web seminar entitled, Cybersecurity Issues for Planners and Their Clients, on Tuesday, December 4, 2018 at 12:00 p.m. Central. Provided below is a description of the event.

Cybersecurity issues for business owners (e.g., identifying exposure points and how to address them), as well as for lawyers themselves, in how they transmit, store and dispose of client information.

October 26, 2018 in Conferences & CLE, Current Affairs, Estate Administration, Estate Planning - Generally, Science, Technology, Trusts, Wills | Permalink | Comments (0)

Tuesday, October 23, 2018

New California Law Puts San Francisco on the Path to Taxing Autonomous Vehicles

AutoThe proposed “robot tax” has taken one step closer to reality with California Governor Jerry Brown’s recent signing of Assembly Bill 1184. The bill authorizes the City and County of San Francisco to impose a tax on each ride originating in San Francisco provided by an automated vehicle, whether facilitated by a rides haring app or another person.

The automated vehicle tax would be capped at 1.5% of net rider fares when a passenger shares a ride with other passengers, and 3.25% of net rider fees when the passenger does not share the ride. The revenues from this tax would be required to be used to fund “transportation operations and infrastructure” within the city.

Though autonomous vehicles are currently in development and the technology is still out of the consumer's grasp, California and San Francisco wanted to be ahead of the economic rush and possible turmoil of switching to such a drastically different system. Drivers would no longer need to pay vehicle license and registration taxes, so the local governments would need to find an equivalent.

See Fisher Phillips, Rise of the Robot Tax? New California Law Puts San Francisco on the Path to Taxing Autonomous Vehicles, Lexology, October 18, 2018.

October 23, 2018 in Current Affairs, Estate Planning - Generally, Science, Technology | Permalink | Comments (1)

Wednesday, October 17, 2018

Article on Digitalisation and the Future of National Tax Systems: Taxing Robots?

RoboJoachim Englisch recently published an Article entitled, Digitalisation and the Future of National Tax Systems: Taxing Robots?, Tax Law: Tax Law & Policy eJournal (2018). Provided below is an abstract of the Article.

It is generally assumed that already in the next decade, the use of labour-saving robots with implemented artificial intelligence will lead to a dramatic transition of the workforce in almost all sectors of production and services. The ensuing loss of jobs that have traditionally been performed by a human employees is likely to result at least temporarily in reduced wage tax and payroll tax revenues, increasing income inequality and a disruption of the labour market. Against this backdrop, the idea of taxing the use of robots that replace human workforce, or even taxing the robots themselves, has emerged in politics and scholarly writings. Several justifications have been brought forward by its proponents: the robot tax has been regarded, respectively, as a corollary to a soon-to-be-expected concession of civil law personhood to robots, as a tax on imputed income earned by means of the robot, as an equalisation levy to restore the level playing field regarding the taxation of robots and of human workers, as an instrument for economically efficient wage compression between winners and losers of automation among the human workforce, or as a corrective tax to slow down the disruption of the labour market.

This paper argues that upon a closer look, the case for taxing robots or their use is relatively weak, though, except when specific conditions are met. There is currently no compelling argument to make robots themselves taxable persons, neither for the purposes of income taxation nor for the purposes of indirect taxes on consumption expenditure. Moreover, significant objections can also be raised regarding suggestions to tax the use of robots. Some of the concepts advanced in literature rely on presumptions that are either conceptually flawed or lack credible empirical support. Other proposals have their merits, but when weighing in on their potential benefits, policymakers will also have to take into account that any tax on robots is liable to result in distortions, complexities, and reduced growth. Besides, proponents of a robot tax tend to underestimate how capital mobility and international tax competition could easily undermine the respective objective of such a tax. As a Pigouvian tax, a robot tax will therefore likely have a very limited field of reasonable application. Regarding income redistribution and revenue raising objectives, the taxation of robots should only be considered as a measure of last resort, and in any event a provisional one. Where politically feasible, priority should instead be given to intensified efforts to tax the return on capital investments and on profits in general, including an adequate taxation of ultimate shareholders. In any event, increasing automation should have implications for the international allocation of taxing rights.

October 17, 2018 in Articles, Estate Planning - Generally, Science, Technology | Permalink | Comments (0)

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)