“Physician-Assisted Suicide is now legal in Canada”

With the passing of new legislation, Canada has become one of the few nations to legalize physician-assisted suicide.  The new law imposes strict requirements, however, by limiting the option to the incurably ill and requiring medical approval, a 15-day waiting period and two independent witnesses. Moreover, to obtain a request for physician-assisted suicide, a patient must: (1) be eligible for government-funded health care; (2) be a mentally competent adult over the age of 18; (3) have a serious and incurable disease, illness or disability; and (4) be in an “advanced state of irreversible decline” with enduring and intolerable suffering.

The legislation is more restrictive than some of the lawmakers had wanted.  Some argued that it should be broadened to include degenerative disease, whereby patients who are suffering from incurable degenerative diseases but are not necessarily close to death would also qualify for physician-assisted suicide. Yet, others believed that such a broad criteria would push the law too far. As Justice Minister Jody Wilson explained, the requirements in the final legislation “strike the right balance between personal autonomy for those seeking access to medically assisted dying and protecting the vulnerable.”

 Source: http://www.npr.org/sections/thetwo-way/2016/06/18/482599089/canada-legalizes-physician-assisted-dying

“Extreme Overvalued Belief” or Mental Illness?

Society and courts of law often find themselves struggling to understand what causes someone to commit a violent act. Mental illness is often cited as the motive for such crimes.  However, Dr. Tahir Rahman, an Assistant Professor of Psychiatry at the University of Missouri’s School of Medicine, has concluded that in some cases, violent crimes are not the result of mental illness but rather an “extreme overvalued belief,” a term Dr. Rahman uses to classify the cause of criminally violent behavior when psychosis can be ruled out.

Dr. Rahman conducted a case study on Andres Breivik, a Norwegian terrorist who claimed to be a “savior of Christianity” after detonating a car bomb that killed 77 people in 2011. A psychiatric team concluded that Breivik was not psychotic and instead diagnosed him with personality disorder. Dr. Rahman suggests, however, that Breivik’s criminal acts were a result of his extreme overvalued belief.  An extreme overvalued belief is “a belief that is shared by others and often relished, amplified and defended by the accused.”  This intense emotional commitment to a particular belief is what causes the accused to commit a violent act.  Dr. Rahman hopes that his study can help forensic psychiatrists properly identify the motive for a crime in courts of law when a defendant’s sanity is in question. Although more research must be done to fully understand the concept of extreme overvalued beliefs, Dr. Rahman also hopes that future research will enable mental health professionals to identify early signs of such extreme beliefs and intervene before violent behavior occurs.

 

Source: https://www.sciencedaily.com/releases/2016/05/160523130806.htm

Texas Abortion Law Struck Down by Supreme Court

On June 27, 2016, the Supreme Court invalidated a Texas law that limited women’s access to abortion. The law required physicians performing pre-viability abortions to have hospital admitting privileges. It also required women’s health centers that offered abortion services to abide by certain surgical center requirements, causing many centers to close.

Proponents of the law claimed that it was an effort to maintain safety standards for women. However in a 5-3 vote, the Supreme Court concluded that the legislation imposed an undue burden on women attempting to obtain an abortion. Justice Breyer explained in his opinion that with the majority of clinics that offered abortions forced to close, the law would require women to travel long distances to the only “crammed-to-capacity” compliant facility. He further stated that nothing in the legislation provided any benefit to women’s health. Justice Ginsburg echoed this conclusion in her concurring opinion by explaining that complications from pre-viability abortions are rare and not life-threatening.

Justice Samuel Alito, Jr. wrote the dissenting opinion, which did not directly speak to the constitutionality of the law. Instead, he focused on the doctrine of res judicata, which prevents recurring litigation on a matter that has already been resolved. Justice Thomas affirmed this argument in a concurring dissent, claiming that the majority has repeatedly “distorted” the law and given preference to pro-choice arguments.

This is the first case the Supreme Court has decided regarding abortion rights in nine years, and while it was by no means a unanimous decision, it affirmed that the undue burden test established in Planned Parenthood v. Casey in 1992 continues to control the constitutionality of abortion laws.

Source: http://www.nytimes.com/2016/06/28/us/supreme-court-texas-abortion.html?_r=0; Marcia Coyle & Tony Mauro, High Court Strikes Down Curbs on Texas Abortion Clinics, N.Y. L.J., June 28, 2016, at 1–2.

 

Congress Looks to Revamp Mental Health System

Soon, Congress will hear testimony concerning the Helping Families in Mental Health Crisis Act. Republican representative, Tim Murphy, from Pennsylvania, sponsored the bill, and, though many agree that the mental health care system requires revamping, some provisions in the bill have sparked controversy. Among the more controversial provisions is one that supports the increased use of involuntary outpatient treatment—via court-ordered therapy for “certain mentally ill people with a history of legal or other problems.” Detractors of this provision claim that it will erode trust in doctor-patient relationships, and that it presents a civil rights issue. However, 45 states have compelled treatment programs already, one of which is New York.

New York’s compelled treatment program, Kendra’s Law, was passed in 1999. Since the implementation of Kendra’s Law, studies show that the percentage of patients returning to the hospital or getting arrested has greatly decreased. The statistic is significant, as “about 350,000 Americans with a diagnosis of severe mental illness…are in state jails and prisons” and the availability of psychiatric beds meets only 10 percent of that need. 

Read more here.

Potentially Dangerous Precedent Possible in Mississippi

Anti-fetal homicide laws were enacted originally to protect mothers of unborn children against violent acts. Yet, in reality, “they’ve led to disproportionate prosecution against African American women who suffer miscarriages.” An ongoing case in Mississippi could set a dangerous precedent with regard to the criminalization of pregnant women for their purportedly reckless acts.  Rennie Gibbs was charged with the murder of her unborn child after it was stillborn when she was 16 years old. Gibbs is being prosecuted for “depraved heart murder” because the autopsy showed that Gibbs had used cocaine during her pregnancy—but the cause of death was originally attributed to the umbilical cord being wrapped around the infant’s neck. That cause of death was never ruled out.

Read more here and here.

Iowa Reconsiders HIV-Specific Laws; Growing National Trend

In 1990, Congress approved the Ryan White Comprehensive AIDS Resources Emergency (CARE) Act. The CARE Act funds support and medical treatment for individuals with HIV. However, under the Act every state had to certify that it had criminal laws that would prosecute individuals with HIV who knowingly exposed others to the disease, even if those exposed did not contract HIV. Individuals who are successfully prosecuted under these laws are listed as sex offenders. In one case in Iowa, a woman was prosecuted successfully even though she claimed that she informed the man that she was HIV positive. He claimed she did not tell him; however, two weeks prior to filing his complaint against her, he was convicted of domestic abuse for hitting her. She is now listed as a sex offender.

Currently, the federal government and advocates consider these HIV-specific laws to be draconian in light of modern scientific knowledge regarding HIV, which is “no longer the death sentence it once was.” Many of these HIV-specific laws do not require exposure in the form of sexual contact, and some even include exposure in the form of something as innocuous as spitting. HIV cannot be transmitted through saliva. Some states, including Iowa, are reconsidering and changing their HIV-specific laws in response to this change in public opinion.

Read more here.

Bitter Battle Rages over Continuing Life Support for Brooklyn Woman

A bitter court battle is raging over whether an elderly Brooklyn woman should continue to be kept alive. Sylvia Sodden, 78, is still on life support, even though her original health care proxy agreed to its removal. In 2011, Sodden appointed her godson, Joe Arrigo, as her health care proxy. Arrigo is Catholic, and states that Sodden converted from Orthodox Judaism to Catholicism when she was 20 years old. He states also that Sodden did not want to be on life support, and that “she didn’t want to end up like this.” He consulted with two priests prior to making the decision to remove life support.

 However, on March 18, 2014 a Brooklyn Supreme Court Judge determined that Esther Feigenbaum, Sodden’s sister, would replace Arrigo as Sodden’s health care proxy. Feigenbaum claims that Sodden never converted, and that shutting down life support is “anathema to Orthodox Jewish belief.” The Court indicated that part of its decision to divest Arrigo of his role as health care proxy rested on the fact that Arrigo was absent from Court on the day of the proceedings. Arrigo maintains that he did not know he was supposed to appear.

Read more here.

Approximately 50% of Americans Believe Health Conspiracy Theories

JAMA Internal Medicine published a research letter by authors J. Eric Oliver, PhD and Thomas Wood, MA, which indicates that almost half of the nation believes in at least one health conspiracy. For example, thirty-seven percent of Americans believe that the Food and Drug Administration is concealing natural cures for cancer in response to industry pressure from pharmaceutical companies. The authors conducted an online survey of 1,351 adults; the survey posited four health conspiracy theories. Forty-nine percent of those polled indicated that they believe at least one of the proposed theories, and eighteen percent believe in at least three. According to Oliver, the takeaway from the survey “is that people who embrace these conspiracies are very suspicious of traditional evidence-based medicine.

Read more here.

D.C. Instructs Insurance Companies to Cover Gender Reassignment Surgery

Mayor Vincent Gray of Washington D.C. announced that D.C. will now require insurance companies to provide full coverage to transgender residents, which includes gender reassignment surgery. The D.C. Department of Insurance, Securities and Banking stated its official position that treatment and gender reassignment surgery for gender dysphoria are covered benefits. The Mayor stated that transgender people should not be required to pay extensive out-of-pocket fees for treatment.

Read more here.

Health Care Debate in Florida Veers Off the Beaten Path

Florida is one of the twenty-four states that declined to expand their Medicaid programs.  As a result, approximately 760,000 Florida residents who would qualify for Medicaid under an expanded Medicaid program do not qualify so qualify. In addition, these residents do not qualify for federal subsidies to help them purchase health insurance. Recently, some Florida legislators honed in on an obscure provision in the Affordable Care Act, which allows low-income documented immigrants to qualify for federal subsidies in order to buy health insurance. The legislators intend to publicize this information in an effort to get the Medicaid expansion approved during the next legislative session. Republican state Sen. Rene Garcia of Hialeah stated that the issue is one of “fairness,” and not immigration.

Read more here.