The Growing Decision Making Power of Healthcare Committees: Why Regulation Is Needed to Assure Due Process Thaddeus M...
 
Due Process The price of deference
<ul><li>Presume </li></ul><ul><ul><ul><li>Medical judgment is best </li></ul></ul></ul><ul><li>Unless </li></ul><ul><u...
Problems with HECs <ul><li>Corruption </li></ul><ul><li>Bias </li></ul><ul><li>Carelessness </li></ul><ul><li>Arbitrarines...
ThaddeusPope.com BePress.com SSRN.com
 
 
 
 
Ethics Committees Make Decisions <ul><li>Gatekeeper </li></ul><ul><li>Residual surrogate </li></ul><ul><li>Adjudicator </l...
HEC as Gatekeeper for substituted judgment NY for the OOIE NJ for PVS FL
HEC as Residual Surrogate
HEC as Adjudicator of Futility Disputes Tex. H&S Code ' 166.046, not modified by , H.B. 3325, Tex. Leg. 81(R)
HEC as Adjudicator of OTHER Disputes broad role HI default surrogates of the same class DE
<ul><li>De facto authority </li></ul><ul><ul><li>“ Lumping” </li></ul></ul><ul><ul><li>Practical barriers to court </li><...
 
 
 
Mandatory use Optional use Mandatory follow Optional follow
Expanding HEC Authority <ul><li>N.Y. S.3164 (Duane) / A.7729 (Gottfried) </li></ul><ul><li>Mike E. Jorgensen, Today Is...
Expanding HEC Authority <ul><li>Idaho </li></ul><ul><li>S.B. 1114, 60 th Leg. (2009) </li></ul>
Expansion Understandable <ul><li>Intractable value conflict </li></ul>Pure procedure
Sloppiness Understandable <ul><li>Developed to disclaim power </li></ul><ul><li>No “stick” = low priority </li></ul><ul><...
Expected evolution Due process Power, authority
Actual evolution Due process Power, authority
Deference to professional judgment <ul><li>Confidence </li></ul><ul><li>Little risk of error </li></ul>1970s Parham v. J.R...
New reasons for LESS deference <ul><li>Greater focus on COI </li></ul><ul><li>Greater focus on bias </li></ul><ul><li>Grea...
HEC of Tomorrow <ul><li>Modeled on other IDR (e.g. HCQIA) </li></ul><ul><li>Modeled on rationing boards </li></ul><ul><li...
<ul><li>Thank you </li></ul>
Thaddeus Mason Pope , J.D., Ph.D. Widener University School of Law 4601 Concord Pike, Room L325 Wilmington, Delaware 1980...
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Pope iccec 05-14-10

This is a law and bioethics presentation about the power and regulation of healthcare ethics committees. - by Professor Thaddeus Pope
Published on: Mar 4, 2016
Source: www.slideshare.net


Transcripts - Pope iccec 05-14-10

  • 1. The Growing Decision Making Power of Healthcare Committees: Why Regulation Is Needed to Assure Due Process Thaddeus Mason Pope, J.D., Ph.D. Widener University School of Law 6 th Int’l Conf. Clinical Ethics Consultation Portland, Oregon $ May 14, 2010
  • 3. Due Process The price of deference
  • 4. <ul><li>Presume </li></ul><ul><ul><ul><li>Medical judgment is best </li></ul></ul></ul><ul><li>Unless </li></ul><ul><ul><ul><li>Uninformed </li></ul></ul></ul><ul><ul><ul><li>Sloppy </li></ul></ul></ul><ul><ul><ul><li>Biased </li></ul></ul></ul><ul><ul><ul><li>COI </li></ul></ul></ul>
  • 5. Problems with HECs <ul><li>Corruption </li></ul><ul><li>Bias </li></ul><ul><li>Carelessness </li></ul><ul><li>Arbitrariness </li></ul>
  • 6. ThaddeusPope.com BePress.com SSRN.com
  • 11. Ethics Committees Make Decisions <ul><li>Gatekeeper </li></ul><ul><li>Residual surrogate </li></ul><ul><li>Adjudicator </li></ul>
  • 12. HEC as Gatekeeper for substituted judgment NY for the OOIE NJ for PVS FL
  • 13. HEC as Residual Surrogate
  • 14. HEC as Adjudicator of Futility Disputes Tex. H&S Code ' 166.046, not modified by , H.B. 3325, Tex. Leg. 81(R)
  • 15. HEC as Adjudicator of OTHER Disputes broad role HI default surrogates of the same class DE
  • 16. <ul><li>De facto authority </li></ul><ul><ul><li>“ Lumping” </li></ul></ul><ul><ul><li>Practical barriers to court </li></ul></ul><ul><ul><li>Judicial deference </li></ul></ul>
  • 20. Mandatory use Optional use Mandatory follow Optional follow
  • 21. Expanding HEC Authority <ul><li>N.Y. S.3164 (Duane) / A.7729 (Gottfried) </li></ul><ul><li>Mike E. Jorgensen, Today Is the Day We Free Electroconvulsive Therapy? 12 Quinn. Health L.J. 1 (2008). </li></ul>
  • 22. Expanding HEC Authority <ul><li>Idaho </li></ul><ul><li>S.B. 1114, 60 th Leg. (2009) </li></ul>
  • 23. Expansion Understandable <ul><li>Intractable value conflict </li></ul>Pure procedure
  • 24. Sloppiness Understandable <ul><li>Developed to disclaim power </li></ul><ul><li>No “stick” = low priority </li></ul><ul><li>Lack of consensus </li></ul>
  • 25. Expected evolution Due process Power, authority
  • 26. Actual evolution Due process Power, authority
  • 27. Deference to professional judgment <ul><li>Confidence </li></ul><ul><li>Little risk of error </li></ul>1970s Parham v. J.R. 1980s Youngberg v. Romeo 1990s Washington v. Harper
  • 28. New reasons for LESS deference <ul><li>Greater focus on COI </li></ul><ul><li>Greater focus on bias </li></ul><ul><li>Greater focus on provider values </li></ul><ul><li>Thicker catalog of HEC errors </li></ul>
  • 29. HEC of Tomorrow <ul><li>Modeled on other IDR (e.g. HCQIA) </li></ul><ul><li>Modeled on rationing boards </li></ul><ul><li>TJC standards and/or legal rules </li></ul><ul><li>Extramural, multi-institutional </li></ul>
  • 30. <ul><li>Thank you </li></ul>
  • 31. Thaddeus Mason Pope , J.D., Ph.D. Widener University School of Law 4601 Concord Pike, Room L325 Wilmington, Delaware 19803 T 302-477-2230 F 901-202-7549 E [email_address] W www.thaddeuspope.com

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