310 likes | 408 Views
The Growing Decision Making Power of Healthcare Committees: Why Regulation Is Needed to Assure Due Process. Thaddeus Mason Pope, J.D., Ph.D. Widener University School of Law. 6 th Int’l Conf. Clinical Ethics Consultation Portland, Oregon $ May 14, 2010. Due Process
E N D
The Growing Decision Making Power of Healthcare Committees: Why Regulation Is Needed to Assure Due Process Thaddeus Mason Pope, J.D., Ph.D. Widener University School of Law 6th Int’l Conf. Clinical Ethics Consultation Portland, Oregon $ May 14, 2010
Due Process The price of deference
Presume • Medical judgment is best Unless • Uninformed • Sloppy • Biased • COI
Problems with HECs • Corruption • Bias • Carelessness • Arbitrariness
ThaddeusPope.com BePress.com SSRN.com
Ethics Committees Make Decisions • Gatekeeper • Residual surrogate • Adjudicator
HEC as Adjudicator of Futility Disputes Tex. H&S Code ' 166.046, not modified by, H.B. 3325, Tex. Leg. 81(R)
De facto authority • “Lumping” • Practical barriers to court • Judicial deference
Expanding HEC Authority • N.Y. S.3164 (Duane) / A.7729 (Gottfried) • Mike E. Jorgensen, Today Is the Day We Free Electroconvulsive Therapy? 12 Quinn. Health L.J. 1 (2008).
Expanding HEC Authority Idaho S.B. 1114, 60th Leg. (2009)
Expansion Understandable Intractable value conflict Pure procedure
Sloppiness Understandable • Developed to disclaim power • No “stick” = low priority • Lack of consensus
Expected evolution Due process Power, authority
Actual evolution Due process Power, authority
Deference to professional judgment • Confidence • Little risk of error 1970sParham v. J.R. 1980sYoungberg v. Romeo 1990sWashington v. Harper
New reasons for LESS deference • Greater focus on COI • Greater focus on bias • Greater focus on provider values • Thicker catalog of HEC errors
HEC of Tomorrow • Modeled on other IDR (e.g. HCQIA) • Modeled on rationing boards • TJC standards and/or legal rules • Extramural, multi-institutional
Thaddeus Mason Pope, J.D., Ph.D. Widener University School of Law 4601 Concord Pike, Room L325 Wilmington, Delaware 19803 T 302-477-2230 F 901-202-7549 E tmpope@widener.edu W www.thaddeuspope.com