End-of-Life Care: Forensic Medicine v. Palliative Medicine

Author:

Pestaner Joseph P.

Abstract

The increasing life expectancy of terminally-ill people has raised many public policy concerns about end-of-life care. Due to increased longevity and the lack of cures for illnesses like cancer and heart disease, palliative care, particularly pain management, has become an important mode OF medical therapy. Palliative care providers feel that “[h]ealth care professionals have a moral duty to provide adequate palliative care and pain relief, even if such care shortens the patient’s life.” Practitioners of forensic medicine grapple with determining when to classify the death of a person formerly receiving palliative care as a non-natural death. Such classification may be paramount in the enforcement of new statutes that aim at preventing assisted suicide or monitoring the quality of health care, but it potentially places forensic medicine and palliative medicine in adversarial roles.

Publisher

Cambridge University Press (CUP)

Subject

Health Policy,General Medicine,Issues, ethics and legal aspects

Reference123 articles.

1. 92 See id.; Personal communication from Ann Dixon, former Deputy Chief Medical Examiner in Baltimore, Maryland, to author (February 25, 2000).

2. 56 See Records of the Office of the Chief Medical Examiner, supra note 24.

3. 42 See Md. Code Ann., [Health–Gen.] § 5–310 (1994) (detailing how the findings of the OCME are challenged): Except in a case of a finding of homicide, a person in interest as defined in § 10–611(e)(3) of the State Government Article may request the medical examiner to correct findings and conclusions on the cause and manner of death recorded on a certificate of death under § 10–625 of the State Government Article within 60 days after the medical examiner files those findings and conclusions. (ii) If the Chief Medical Examiner denies the request of a person in interest to correct findings and conclusions on the cause of death, the person in interest may appeal the denial to the Secretary, who shall refer the matter to the Office of Administrative Hearings. A contested case hearing under this paragraph shall be a hearing both on the denial and on the establishment of the findings and conclusions on the cause of death. (iii) The administrative law judge shall submit findings of fact to the Secretary. (iv) After reviewing the findings of the administrative law judge, the Secretary, or the Secretary's designee, shall issue an order to: 1. Adopt the findings of the administrative law judge; or 2. Reject the findings of the administrative law judge, and affirm the findings of the medical examiner. (v) The appellant may appeal a rejection under subparagraph (iv) 2 to a circuit court of competent jurisdiction. (vi) If the final decision of the Secretary, of the Secretary's designee, or of a court of competent jurisdiction on appeal, establishes a different finding or conclusion on the cause or manner of death of a deceased than that recorded on the certificate of death, the medical examiner shall amend the certificate to reflect the different finding or conclusion under §4–212 and § 4–214 of this article and § 10–625 of the State Government Article.

4. 69 See id.

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1. Who's in Charge in the Intensive Care Unit?;End-of-Life Communication in the ICU;2008

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3. Accusations of Murder and Euthanasia in End-of-Life Care;Journal of Palliative Medicine;2005-12

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