Premiere Date: March 20, 2014
Expiration Date: March 20, 2015 [Expired]
This activity offers CE credits for:
1. Physicians (CME)
All other clinicians will either receive a CME Attendance Certificate or may choose any of the types of CE credit being offered.
This article reviews end-of-life decision making by providing the information on associated legal decisions as well as a personal account of what is involved in making the final decision.
At the end of this CE activity, participants should be able to:
1. Identify the legal cases that led to the right to refuse treatment.
2. Understand what the role of a psychiatrist is in end-of-life decisions.
3. Understand the process in end-of-life decisions.
This continuing medical education activity is intended for psychiatrists, psychologists, primary care physicians, physician assistants, nurse practitioners, and other health care professionals who seek to improve their care for patients with mental health disorders.
CME Credit (Physicians): This activity has been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education through the joint sponsorship of CME Outfitters, LLC, and Psychiatric Times. CME Outfitters, LLC, is accredited by the ACCME to provide continuing medical education for physicians.
CME Outfitters designates this enduring material for a maximum of 1.5 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
Note to Nurse Practitioners and Physician Assistants: AANPCP and AAPA accept certificates of participation for educational activities certified for AMA PRA Category 1 Credit™.
It is the policy of CME Outfitters, LLC, to ensure independence, balance, objectivity, and scientific rigor and integrity in all of their CME/CE activities. Faculty must disclose to the participants any relationships with commercial companies whose products or devices may be mentioned in faculty presentations, or with the commercial supporter of this CME/CE activity. CME Outfitters, LLC, has evaluated, identified, and attempted to resolve any potential conflicts of interest through a rigorous content validation procedure, use of evidence-based data/research, and a multidisciplinary peer-review process.
The following information is for participant information only. It is not assumed that these relationships will have a negative impact on the presentations.
Richard Martinez, MD, MH, has no disclosures to report.
Casey Frank, JD, MPH, has no disclosures to report.
Cynthia Geppert, MD, PhD, MPH, (peer/content reviewer) has no disclosures to report.
Applicable Psychiatric Times staff have no disclosures to report.
UNLABELED USE DISCLOSURE
Faculty of this CME/CE activity may include discussion of products or devices that are not currently labeled for use by the FDA. The faculty have been informed of their responsibility to disclose to the audience if they will be discussing off-label or investigational uses (any uses not approved by the FDA) of products or devices. CME Outfitters, LLC, and the faculty do not endorse the use of any product outside of the FDA-labeled indications. Medical professionals should not utilize the procedures, products, or diagnosis techniques discussed during this activity without evaluation of their patient for contraindications or dangers of use.
Questions about this activity?
Call us at 877.CME.PROS
Dr Martinez is Robert D. Miller Professor of Psychiatry and Law and Director of the Forensic Psychiatry Fellowship program at the University of Colorado Denver School of Medicine, Department of Psychiatry; Director of Forensic Psychiatry at Denver Health Medical Center; and Adjunct Professor at Denver University Sturm School of Law.
Mr Frank practices law in Colorado, and he is Senior Instructor in Forensic Psychiatry, University of Colorado at Denver School of Medicine. He has been a consultant for over 15 years on the University of Colorado Hospital ethics committee.
1. Schloendorff v Society of New York Hospital, 211 NY 125, 129-130 (1914).
2. In re Quinlan, 70 NJ 10, 41 (1976).
3. In re Quinlan, 70 NJ 10, 54 (1976).
4. Abram MB, Chair. Deciding to forego life-sustaining treatment: ethical, medical, and legal issues in treatment decisions. President’s Commission for the Study of Ethical Problems in Medicine and Biomedical and Behavioral Research; March, 1983. https://bioethicsarchive.georgetown.edu/pcbe/reports/past_commissions/de.... Accessed February 14, 2014.
5. American Medical Association. Opinion 2.20: Withholding or Withdrawing Life-Sustaining Medical Treatment. http://www.ama-assn.org//ama/pub/physician-resources/medical-ethics/code.... Accessed February 14, 2014.
6. Elizabeth Bouvia v Superior Court of California, 179 Cal App 3d 1127 (1986).
7. Elizabeth Bouvia v Superior Court of California, 179 Cal App 3d 1143 (1986).
8. In re Conroy, 98 NJ 321, 359-368; 1985.
9. Matter of Westchester County Medical Center on Behalf of O’Connor, 72 NY2d 517, 534 (NY App 1988).
10. Miller TE. New York adopts broad changes to law on treatment decisions. NY Law J. 2010:243.
11. Cruzan v Director, Missouri Department of Health, 497 US 261 (1990).
12. Colby WH. Long Goodbye: The Deaths of Nancy Cruzan. Carlsbad, Calif: Hay House Inc; 2002.
13. Quill TE. Terri Schiavo: a tragedy compounded. N Engl J Med. 2005;352:1630-1633.
14. Cerminara K, Goodman K. University of Miami Ethics Program: Terri Schiavo Case Resources. http://www.miami.edu/index.php/ethics/projects/schiavo/. Accessed February 14, 2014.
15. Torpy JM, Kincaid JL, Glass RM. Brain death. JAMA. 2009;301:1192.
16. Colorado Revised Statute §12-36-136, Determination of Death.
17. Onishi N. California: girl declared dead is transferred. New York Times. January 7, 2014:A13.
18. Damasio A. Self Comes to Mind. New York, NY: Pantheon; 2010:158-162.
19. Frankel G. Ariel Sharon dies at 85: former Israeli prime minister epitomized country’s warrior past. Washington Post. January 11, 2014. http://www.washingtonpost.com/local/obituaries/ariel-sharon-dies-at-85-f.... Accessed February 14, 2014.
20. Baeke G, Wils JP, Broeckaert B. Orthodox Jewish perspectives on withholding and withdrawing life-sustaining treatment. Nursing Ethics. 2011;18:835-846.
21. Washington v Glucksberg, 117 SCt 2258, 2274 (1997).
22. Vacco v Quill, 117 SCt 2293, 2302 (1997).
23. Oregon Revised Statutes 127.815; Washington Statute 70.245.060.
24. Brandeis L, Warren S. The right to privacy. Harvard Law Rev. 1890;4:193.
25. Newlywed father-to-be, 32, chooses to go off life support and die ONE DAY after he fell from tree and became paralyzed. Mail Online. November 2013. http://www.dailymail.co.uk/news/article-2487986/Newlywed-Tim-Bowers-choo.... Accessed February 14, 2014.
26. Kirschner KL. Calling it quits: when patients or proxies request to withdraw or withhold life-sustaining treatment after spinal cord injury. Top Spinal Cord Injury Rehab. 2008;13:30-44.
27. Patterson DR, Miller-Perrin C, McCormick TR, Hudson LD. When life support is questioned early in the care of patients with cervical-level quadriplegia. N Engl J Med. 1993;328:506-509.