Appeal to the Rule of Rescue in health care: discriminating and not benevolent?

AbstractThis paper tests the factorial structure of a questionnaire comprising seven health care rationing criteria (waiting time, ‘rule of rescue’, parenthood of minors, health maximization, youngest first, positive and negative version of social merit) and explores the adherence to them of 254 Portuguese health care professionals, when considered individually and when confronted with two-in-two combinations. Data were collected through a self-administered questionnaire where respondents faced hypothetical rationing dilemmas comprising one rationing criterion and dichotomous options pairs with two rationing criteria. Confirmatory factor analysis and multinomial logistic regressions were used to validate the structure of the questionnaire and the data. The findings suggest that: (i) the hepta-factorial structure of the questionnaire presented a good fit of the data; and (ii) support for rationing criterion depends on whether they are individually considered or confronted in dichotomous options pairs. When only one criterion distinguishes the patients, healthcare professionals support six criteria (by descending order): waiting time, rule of rescue, health maximization, penalization of patients’ risky behaviors, youngest first and being parent of a young child. When two criteria were confronted, immediate threat of life/health and large expected benefits were the most preferred. Conversely, the positive version of social merit was an unappreciated rationing criterion.

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San Francisco Health Care Ordinance Withstands ERISA Preemption Challenge—Golden Gate Rest. Ass'n v. City & County of S.F.

American Journal of Law & Medicine ◽

10.1017/s0098858800001428 ◽

2009 ◽

Vol 35 (4) ◽

pp. 700-703

Author(s):

Stephen Pessagno

Keyword(s):

Health Care ◽

San Francisco ◽

Golden Gate

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Malpractice & Negligence: Cal. Supreme Court Clarifies Negligence Provisions under State’s Elder Abuse Act

The Journal of Law Medicine & Ethics ◽

10.1017/s1073110500012973 ◽

1999 ◽

Vol 27 (2) ◽

pp. 203-203

Author(s):

Kendra Carlson

Keyword(s):

Health Care ◽

Supreme Court ◽

Health Care Providers ◽

Elder Abuse ◽

Skilled Nursing Facility ◽

Pressure Sores ◽

Care Providers ◽

Nursing Facility ◽

Skilled Nursing ◽

The Supreme Court

The Supreme Court of California held, in Delaney v. Baker, 82 Cal. Rptr. 2d 610 (1999), that the heightened remedies available under the Elder Abuse Act (Act), Cal. Welf. & Inst. Code, §§ 15657,15657.2 (West 1998), apply to health care providers who engage in reckless neglect of an elder adult. The court interpreted two sections of the Act: (1) section 15657, which provides for enhanced remedies for reckless neglect; and (2) section 15657.2, which limits recovery for actions based on “professional negligence.” The court held that reckless neglect is distinct from professional negligence and therefore the restrictions on remedies against health care providers for professional negligence are inapplicable.Kay Delaney sued Meadowood, a skilled nursing facility (SNF), after a resident, her mother, died. Evidence at trial indicated that Rose Wallien, the decedent, was left lying in her own urine and feces for extended periods of time and had stage I11 and IV pressure sores on her ankles, feet, and buttocks at the time of her death.

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A Tribute to the Late William J. Curran

The Journal of Law Medicine & Ethics ◽

10.1017/s1073110500004058 ◽

1996 ◽

Vol 24 (3) ◽

pp. 274-275

Author(s):

O. Lawrence ◽

J.D. Gostin

Keyword(s):

Mental Health ◽

Health Care ◽

Mental Illness ◽

United Nations ◽

Mental Health Care ◽

Harvard University ◽

Legal Medicine ◽

General Assembly ◽

International Institute ◽

University Professor

In the summer of 1979, a group of experts on law, medicine, and ethics assembled in Siracusa, Sicily, under the auspices of the International Commission of Jurists and the International Institute of Higher Studies in Criminal Science, to draft guidelines on the rights of persons with mental illness. Sitting across the table from me was a quiet, proud man of distinctive intelligence, William J. Curran, Frances Glessner Lee Professor of Legal Medicine at Harvard University. Professor Curran was one of the principal drafters of those guidelines. Many years later in 1991, after several subsequent re-drafts by United Nations (U.N.) Rapporteur Erica-Irene Daes, the text was adopted by the U.N. General Assembly as the Principles for the Protection of Persons with Mental Illness and for the Improvement of Mental Health Care. This was the kind of remarkable achievement in the field of law and medicine that Professor Curran repeated throughout his distinguished career.

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