December 21st, 2006

Man who sparked euthanasia debate dies

It isn’t quite New York personal injury law, but sufficiently interesting to deserve note: An Italian patient that wanted to die by being pulled off his respirator. Since we see “right to die” issues all the time where medicine meets the law, I wanted to share this one:

ROME – A paralyzed man at the center of a right-to-die debate in this overwhelmingly Roman Catholic nation died after he was taken off his respirator, days after an Italian court issued a contentious ruling in the case.

Piergiorgio Welby, 60, died late Wednesday, said Dr. Mario Riccio, the physician who removed the respirator. Riccio said Thursday that Welby had a constitutionally guaranteed right to refuse treatment.

“This must not be mistaken for euthanasia. It is a suspension of therapies,” said Riccio, who volunteered to remove the respirator and was not involved in Welby’s medical care. “Refusing treatment is a right.”

…

On Saturday, a Rome judge recognized Welby’s right to refuse treatment but ruled that doctors were not obligated to take measures that would result in the patient’s death — even at the patient’s request.
…

U.S. law generally permits patients to ask that medical treatment be withheld or withdrawn, even if it raises their risk of dying. Voters in Oregon went further and approved the first physician-assisted suicide law in the U.S. in 1994, but it is now under legal challenge.

In 2001, the Netherlands became the first country to legalize voluntary euthanasia — where patients are killed at their request to ease suffering, even in cases where they might survive without treatment. Belgium legalized it under strict conditions in 2002.

December 6th, 2006

Two Personal Injury Lawyers Sentenced in Billing Scam

I never liked the “Blue Code of Silence” that cops use to protect the bad apples, and I don’t like the “White Coat of Silence” that some doctors use to protect each other. So if I don’t like it for others, then I won’t do it myself.

Which brings me to this AP story that appeared last week in Newsday:

NEW YORK (AP) – Two personal injury lawyers who pleaded guilty to stealing hundreds of thousands of dollars from clients were sentenced Thursday to community service and five years probation after repaying the money they stole.

Michael Mann, of Little Silver, N.J., and Joshua Just, of Manhattan, pleaded guilty in August to scheme to defraud. They admitted that from 2003 through 2005 their Manhattan law firm, Mann & Just LLP, stole at least $275,000 from at least 10 clients by charging for expenses the firm never incurred.

While some in other professions may look away from their own problems — and every business or industry has them, from teachers to clerics –I don’t think that we should follow that script. There are bad actors in every business, and the others in the business ought to be on the front lines of cleaning it up, not hiding it. And so I give this story just a tiny bit more of publicity.

Because the plea deal was for felony conviction, both people will be disbarred. As they should.

November 18th, 2006

Hospitals are not healthy

A recent op-ed in the New York Times reminds us again that a hospital is not just a good place to get better, but also a great place to get sick. That’s not being cute, but simply reminding us that about 100,000 people die each year from infections they acquire in the hospital. The author of the column, former lieutenant governor of New York Betsy McCaughey, points out that this is five times as many as die of AIDS in this country.

The killer bacteria are known as MRSA., or methicillin-resistant Staphylococcus aureus. MRSA, which by definition is resistant to antibiotics, increased in the United States by 32 times from 1976 to 2003, according to the Centers for Disease Control. While staph infections comprised only 2% percent of hospital infections in 1976, it is now 60 %.

Infections are carried from patient to patient due to sloppy institutional practices, as germs travel on gowns, gloves, bedrails, stethoscopes, wheelchairs and even blood pressure cuffs. Prevention comes in the form of testing people for the bacteria that causes the problem, and isolating those individuals. The cost of illness and death vastly outpaces the cost of testing.

The sad truth is that so many of these infections and deaths are preventable. Other developed nations, faced with rapid growth of the problem, have nearly eradicated it with testing.

Ms. McCaughey, who is also the founder of the Committee to Reduce Infection Deaths, writes:

Treating hospital infections costs an estimated $30.5 billion a year in the United States. Prevention, on the other hand, is inexpensive and requires no capital outlays. A pilot program at the University of Pittsburgh found that screening tests, gowns and other precautions cost only $35,000 a year, and saved more than $800,000 a year in infection costs. A review of similar cost analyses, published in The Lancet in September, concluded that M.R.S.A. screening increases hospital profits — as it saves lives.

The failure to take proper preventative measures is institutional malpractice, and has caused extraordinary suffering and loss. Must hospitals wait to be hit by juries with large liability awards before they change their conduct?