28th Annual Health Law Symposium

Friday, April 1, 2016 -
9:00am to 4:15pm

John K. Pruellage Courtroom

Saint Louis University School of Law Center for Health Law Studies and the
Saint Louis University Journal of Health Law & Policy present the 28th Annual Health Law Symposium:

Dying Fast and Slow: Improving Quality of Dying and Preventing Untimely Deaths

This day-long conference will engage ongoing ethical and legal questions about policies and practices that hinder effective communication about dying, impact utilization and quality of services that improve dying—such as palliative care and hospice—and lead to conflict and engagement of the legal system at end of life. In addition, conference participants will address untimely death—such as accidental overdoses, suicides, and pediatric mortality—and offer policy suggestions to decrease premature death and improve quality of dying.


6.0 MO CLE Credits Available


Video

Session One: Talking About and Planning for Dying

Session Two: Policy Solutions to Improve Quality at the End of Life

Session Three: Untimely Deaths in Highly Stigmatized Populations

Session Four: Improving Quality at the End of a Child's Life


Schedule

8:30 - 9 AM: REGISTRATION


9 - 9:10 AM: WELCOME


9:10 - 10:20 AM: SESSION ONE: TALKING ABOUT AND PLANNING FOR DYING

“Family Communication Around End-of-Life Planning and Decision Making: Managing Uncertainty and Making Sense of Communication About the End of Life”
 Jennifer Ohs, PhD
Assistant Professor, Department of Communication, Saint Louis University
April Trees, PhD
Associate Professor and Chair, Department of Communication, Saint Louis University 

“Is There a Moral Obligation of Health Systems to Develop Robust Advance Care Planning Programs?”
Thomas D. Harter, PhD 
Director, Center for Bioethics, Humanities, and Advance Care Planning, Gundersen Health System

“Death as Failure?”
Miguel Paniagua, MD, FACP
Medical Advisor, National Board of Medical Examiners; Adjunct Associate Professor, Perelman School of Medicine, University of Pennsylvania


10:20 - 10:35 AM: BREAK


10:35 - 11:45 AM: SESSION TWO: POLICY SOLUTIONS TO IMPROVE QUALITY AT THE END OF LIFE 

“From Medicare to Obamacare: The Ethical Evolution of US Hospice Care”
Harold Braswell, PhD
Assistant Professor, Albert Gnaegi Center for Health Care Ethics, Saint Louis University

“Perpetual Legal Calibration: Balancing Risks of Unwanted Life and Unwanted Death”
Thaddeus Mason Pope, JD, PhD 
Professor of Law; Director of the Health Law Institute, Mitchell Hamline School of Law

“Advance Directive Statutes: Guarding State Interests at the Expense of Liberty”
Kathy Cerminara, JD, LLM, JSD
Professor of Law, Shepard Broad Law Center, Nova Southeastern University 


11:45 AM - 1 PM: LUNCH


1:20 - 2:10 PM: SESSION THREE: UNTIMELY DEATHS IN HIGHLY STIGMATIZED POPULATIONS

“Suicide, Sudden Death and Opioids”
Kelly Dineen, JD, PhD, RN
Assistant Professor of Health Law & Ethics, Saint Louis University 

“Suicide in Individuals with Gambling Disorder”
Stacey A. Tovino, JD, PhD
Lehman Professor of Law, UNLV William S. Boyd School of Law; Director, UNLV Health Law Program


2:10 - 2:25 PM: BREAK


2:25 - 3:15 PM SESSION FOUR: IMPROVING QUALITY AT THE END OF A CHILD'S LIFE

“Technological Interventions in Resuscitation: The Ethics of Decision Making for Critically Ill Children”
Jay Malone, MD, MS
Pediatric Critical Care Medicine Fellow, Washington University School of Medicine

“Footprints Pediatric and Palliative Care Program: Developing a Voice for the Voiceless and Why It’s Important”
Sr. Judith Carron, RSM, BSN
Care Coordinator, Footprints Program, SSM Cardinal Glennon Children’s Hospital


3:15 - 4:15 PM: SESSION FIVE: INCORPORATION NEW DEVELOPMENTS IN THE POLICY AND PRACTICE OF DYING

All speakers will participate in this Question & Comment session


Speakers

HAROLD BRASWELL, PhD
Assistant Professor, Albert Gnaegi Center for Health Care Ethics, Saint Louis University

Harold Braswell is an Assistant Professor at the Albert Gnaegi Center for Health Care Ethics. His research and teaching examine the intersection of disability studies and bioethics, with a particular focus on end-of-life care. He is currently completing a book manuscript, A Dying Family: US Hospice Care and the Crisis of Freedom at the End-of-Life (under contract with Johns Hopkins University Press). This book examines the implications of the design of US hospice care for bioethical debates about freedom at the end-of-life. It draws on a year-and-a-half of ethnographic fieldwork in various Atlanta-area hospices, as well as original archival research on the modern US hospice movement. His articles have appeared in Hypatia, Social Science and Medicine, the Journal of Medical Humanities, Disability Studies Quarterly, and the American Journal of Bioethics Neuroscience. His scholarship has won awards from the Hastings Center, the Society for Disability Studies, and the University of Chicago Program on Medicine and Religion. He is the organizer of the Society for Disability Studies interest group for family members of persons with disabilities.


KATHY CERMINARA, JD, LLM, JSD
Professor of Law, Nova Southeastern University Shepard Broad College of Law

Professor Kathy Cerminara bridges the medical and legal professions with her work on patients’ rights in the end-of-life decision-making arena.  She co-authors the nationally known treatise, The Right to Die: The Law of End-of-Life Decisionmaking, and is a reviewer for several medical and medical-legal journals.  Her scholarship most recently has focused on the intersection between end-of-life care, palliative care, and health care coverage policy.  At the Nova Southeastern University Shepard Broad College of Law, she is a full professor and serves as Director of Faculty Development. Read more here.


SR. JUDITH CARRON, RSM, BSN
Care Coordinator, Footprints Program, SSM Cardinal Glennon Children’s Hospital

Sister Judy Carron is one of the coordinators of the Footprints program, a program at Cardinal Glennon for any child dealing with a complex illness.  Footprints coordinators meet with families before the baby’s birth, keep in contact with families after the birth, and serve as support system and advocate both before and after the baby is born.  Sister Judy Carron, a Sister of Mercy, has worked as a nurse and chaplain in pediatrics for many years, and loves her job as Footprints coordinator.  She has learned so much from children and families about what is important in life, especially that life is precious and that we should never take it for granted.  She learns from her patients the greatness and strength of the human spirit. She encourages patients to bring a list of questions and to feel free to ask about any concern they have.  She has always been drawn to the field of maternal-fetal medicine because she believes life is sacred and is a gift, no matter how fragile or how small.  She loves helping parents be involved with their babies in the womb and celebrate their baby, no matter what the circumstances. Outside of work, Sister Judy Carron lives with two other Sisters of Mercy in Kirkwood, and enjoys spending time with her family and friends.  In addition, she loves being outside, planting flowers, walking her dog, watching Cardinal baseball, and learning about current affairs.


KELLY DINEEN, JD, PhD, RN
Assistant Professor of Health Law & Ethics, Saint Louis University

Kelly Dineen is Assistant Professor and holds a joint appointment in the School of Law and Center for Health Care Ethics. She is the Assistant Director of the Center for Health Care Ethics and Co-Director of the Bander Center for Medical Business Ethics. She previously served as the Assistant Dean for Academic Affairs and as the Assistant Director of the Center for Health Law Studies at the School of Law. Dr. Dineen teaches Bioethics and the Law and FDA: Law & Policy at the School of Law and Bioethics and the Law to undergraduate and graduate students in the Center for Health Care Ethics.  Dineen practiced nursing for a decade prior to entering law school. She began in a neurosurgical and organ transplant intensive care unit and later worked as a neurosurgical clinical and research nurse at an academic medical center. She has extensive clinical experience in caring for patients with implanted programmable neuromodulation devices and assisted in the development of one of the first centers in the Midwest to provide functional neurosurgery for patients with movement disorders and chronic intractable pain. Dineen's research interests include the intersection of ethics, law and policy in the treatment of disenfranchised populations (including people with chronic pain or cognitive and neuropsychiatric conditions); end of life care; conflicts of interest in medicine, especially involving medical devices; health care provider decision making and moral development; and clinical research ethics.


THOMAS D. HARTER, PhD 
Director, Center for Bioethics, Humanities, and Advance Care Planning, Gundersen Health System

Dr. Harter is the Director of the Center for Bioethics, Humanities, and Advance Care Planning at Gundersen Health System in La Crosse, WI where leads clinical ethics consultations, education, and bioethics research. He also chairs the Ethics Committee and IRB.  His research primarily focuses on ethical issues at the intersection of business, medicine, and now also advance care planning, including: Conflicts of interest between medicine and industry; using business ethics models to (re)frame current models of clinical ethics consultation; the role of IRBs in determining appropriate compensation for participation in human subjects research; understanding what it means for bioethicists/clinical ethicists to add value to a hospital or health system, and the ways that best capture that value; how concepts within business ethics can help us think about, redefine, and reapply important concepts within medical ethics; the philosophical and ethical justifications of advance care planning; the economics of advance care planning; and the applicability of principles/values of advance care planning apply to other areas of clinical decision-making and clinical ethics consultation.


 JAY MALONE, MD, MS
Pediatric Critical Care Medicine Fellow, Washington University School of Medicine

Dr. Jay Malone is a pediatric critical care fellow and a PhD student in Health Care Ethics.  He obtained his  MS in Health Care Ethics from Creighton University.  Malone’s research focus is in pediatric critical care, specifically issues of surrogate decision making and end-of-life care.


JENNIFER OHS, PhD
Assistant Professor, Department of Communication, Saint Louis University

Jennifer E. Ohs is an Assistant Professor in the Department of Communication at Saint Louis University. Dr. Ohs’s research specialization lies at the intersection of interpersonal and health communication, with a focus on aging and intergenerational communication. Her scholarly work has examined decision-making in the context of medical decisions in older adulthood and end-of-life care decisions in families. Additionally, she is involved in interdisciplinary work that examines personal health information management at different points in the adult lifespan and the role of health information technology in that process. Finally, her work has advanced understanding of the role of communication in ageism across a variety of social contexts to promote healthy intergenerational communication. Her work has appeared in such journals as AIMS Public Health, Qualitative Communication Research, and The Journal of Social Issues. Additionally, she has authored chapters in works such as Routledge Handbook of Applied Communication Research, theEncyclopedia of Health Communication and Contemporary Case Studies in Health Communication: Theoretical & Applied Approaches.

 


MIGUEL PANIAGUA, MD, FACP
Medical Advisor, National Board of Medical Examiners; Adjunct Associate Professor, Perelman School of Medicine, University of Pennsylvania

Dr. Paniagua is an internist, geriatrician and palliative medicine physician who serves as Medical Advisor for Test Development Services at the National Board of Medical Examiners (NBME). His work at the NBME includes development of assessments of procedural skills, communication skills, interprofessional team work and professionalism in the computer-based examinations. Dr. Paniagua served as the internal medicine residency program director at Saint Louis University, Saint Louis, Missouri for five years prior to his appointment at NBME. He graduated from Saint Louis University and received his MD from the University of Illinois College of Medicine, Chicago. Dr. Paniagua completed his internal medicine residency and gerontology & geriatric medicine fellowship at the University of Washington, Seattle, WA. He is a Diplomate of the American Board of Internal Medicine, with sub-specialty certifications in Geriatric Medicine and Hospice and Palliative Medicine. He practices consultative Hospice & Palliative Medicine at The Hospital of University of Pennsylvania and holds adjunct appointments to the faculties of both Saint Louis University School of Medicine and the Perelman School of Medicine at the University of Pennsylvania.  Dr. Paniagua has served on multiple item writing and reviewing committees at the NBME in the past ten years, and served as a representative member of the National Board (2011-14) as well as a year on the NBME Executive Board (2013-14).


THADDEUS POPE, JD, PhD
Director, Health Law Institute; Professor of Law, Mitchell Hamline School of Law

Thaddeus Mason Pope is Director of the Health Law Institute and Professor of Law and at Mitchell Hamline School of Law. He is also an Adjunct Professor with the Australian Centre for Health Law Research at Queensland University of Technology; Adjunct Associate Professor with the Alden March Bioethics Institute at Albany Medical College; and Visiting Professor of Medical Jurisprudence at St. Georges University. Professor Pope has over 120 publications in: leading medical journals, law reviews, bar journals, nursing journals, bioethics journals, and book chapters. He also coauthors the definitive treatise The Right to Die: The Law of End-of-Life Decisionmaking, and runs the Medical Futility Blog (with over one million page views). Professor Pope works to calibrate the balance between individual liberty and public health in the end-of-life medical treatment context. Specific research topics have included: medical futility, ethics committees, brain death, advance directives, surrogate decision making, aid in dying, and VSED. More recently, Pope has been innovating new legal tools to better assure adequate informed consent and fair internal dispute resolution mechanisms. Prior to joining academia, Professor Pope practiced at Arnold & Porter LLP and clerked on the U.S. Court of Appeals for the Seventh Circuit. Pope earned a JD and PhD in philosophy and bioethics from Georgetown University.


STACEY A. TOVINO, JD, PhD
Director, UNLV Health Law Program; Lehman Professor of Law, UNLV William S. Boyd School of Law

Professor Stacey A. Tovino is a leading expert in health law, bioethics, and the medical humanities. She has particular expertise in the civil, regulatory, operational, and financial aspects of health law, and she frequently explores issues that lie at the intersection of health law and other fields, such as gaming law, insurance law, and immigration law. Educated as both an attorney and a medical humanist, Professor Tovino publishes her interdisciplinary work in textbooks, casebooks, edited readers, law reviews, medical and science journals, and ethics and humanities journals. Recent law review publications include articles in the Minnesota Law Review, Washington Law Review, Boston College Law Review, Washington and Lee Law Review, Tulane Law Review, Utah Law Review, Florida State University Law Review, Houston Law Review, University of Richmond Law Review, Kentucky Law Journal, Penn State Law Review, Harvard Journal on Legislation, and Harvard Journal of Law and Gender, among many other general and specialty journals.

Professor Tovino's second book, The HIPAA Privacy Rule: Theory, Practice, and Policy, is forthcoming by Carolina Academic Press in 2016. Professor Tovino's other 2016 research projects relate to the lack of access to mental health care by immigration detainees, Medicare and Medicaid financing of graduate medical education, the legal treatment of individuals with gambling disorder, the health care fraud and abuse implications of certain physician recruitment practices, and the implications of advances in neuroscience for health insurance law, disability benefit law, and disability discrimination law. Professor Tovino is a frequent speaker on the local, national, and international level. She has been invited to guest lecture and present papers on a range of health law, bioethics and medical humanities topics at schools of law, medicine, public health, pharmacy, life sciences, health sciences and public policy, as well as undergraduate and graduate departments of neuroscience, biology, psychology, sociology, philosophy, and humanities across the country.

Prior to joining the faculty at Boyd, Professor Tovino served as Director of the Health Law and Policy Center and Associate Professor of Law at Drake University Law School (2008-10); Assistant Professor of Law at Hamline University School of Law (2006-08); Visiting Assistant Professor, Research Professor, and Adjunct Professor at the University of Houston Law Center (2003-06); and attorney in the Health Industries Group of the Houston office of the international law firm Vinson & Elkins (1997-2003). During her practice, Professor Tovino represented physicians, scientists, allied health professionals, general and special hospitals, academic medical centers, organ procurement organizations, blood banks, AIDS clinics, and nonprofit health care organizations in civil and regulatory matters.


APRIL TREES, PhD
Associate Professor and Chair, Department of Communication, Saint Louis University

April R. Trees is an Associate Professor and Department Chair in the Department of Communication at Saint Louis University.  Dr. Trees’s research centers on communication about difficult or stressful experiences, particularly in the context of close personal relationships like the family. Her research investigates both traditional social support processes as well as narrative and storytelling processes. Understanding more about the communicative activities that help individuals deal with stressors has significant consequences for both individual and relational well-being. Her research with Dr. Jennifer Ohs focuses on end-of-life decision making in the family, a context where family and health communication intersect and individuals must negotiate technical, emotional, and relational meanings as they talk about emotionally-charged, difficult decisions. Her work has been published in a variety of journals, including Communication Monographs, Human Communication Research, Journal of Social and Personal Relationships, Western Journal of Communication, Southern Journal of Communication, Communication Studies, and Journal of Family Communication, and edited books, includingThe Sage Handbook of Family Communication, Talking about Genetics: Family Matters, and Contemporary Case Studies in Health Communication.

  


SARA van den BERG, PhD
Professor, English Department, Saint Louis University

Sara van den Berg received her B.A. summa cum laude from the University of Minnesota, and her M.A., M.Phil., and Ph.D. from Yale University. She chaired the SLU English Department from 2000 to 2012, after teaching at Fordham, Fairfield, Occidental College, The Ohio State University, and the University of Washington-Seattle. Her research has been supported by awards from the Huntington Library, NEH, the University of Washington Royalty Fund, the SLU Presidential Research Fund, and the Medical Humanities Institute at the University of Texas Medical Branch-Galveston. She received the English Department Distinguished Teaching Award at the University of Washington, and the University Distinguished Teaching Award at Ohio State. She is a former member of the editorial board of Modern Language Quarterly and ANQ: American Notes and Queries, and currently serves on the editorial boards of The Ben Jonson Journal, PSY-Art: An Online Journal of Psychology and the Arts, Appositions, and EME: Explorations in Media Ecology. In 2011-2012, she edited two special issues of Allegorica in memory of Thomas Moisan, who had served as Editor of the journal and Chair of the SLU English Department. She also founded the Walter J. Ong, S.J., Center for Language and Media at SLU. She has chaired the MLA Executive Committee for the Division of Psychological Approaches to Literature, and in 2012-13 chairs the MLA Committee on Disability Issues in the Profession. She serves on the Executive Committee of the Gnaegi Center for Healthcare Ethics and the Advisory Board of the Center for Medieval and Renaissance Studies at Saint Louis University.


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Amy Sanders

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