Court Case 12-1

FACTS: During a six-year period after the Family Planning Services and Population Research Act of 1970 was passed, it is estimated that 25% or more Native American women were sterilized either through pressure, lies, or even without consent.The law allowed for the sterilization of patients who received their healthcare from Indian Health Services (IHS) and Medicaid patients.

One case concerned a Native American woman who went to a doctor asking for a womb transplant, because she was initially told that the procedure was reversible. Another case involved a Native American woman who discovered that during an appendectomy her tubes were tied without her consent.

A final report based on data from the US General Accountability Office was highly controversial. The report identified that IHS consent policies were noncompliant and most did not identify whether or not the chance to consent had even been presented to the patient. Senator James Abourezk of South Dakota pointed out that while the reported number of 3,406 sterilizations was startling, it was even more startling to see that only four of the twelve IHS hospitals were investigated.

ISSUE:Were Native American women being sterilized against their will, and did the law allow it?

RULE: Addressing forced sterilization laws, Justice Oliver Wendell Holmes stated in his decision on the US Supreme Court Case Buck v Bell:

"... it is better for all the world if instead of waiting to execute degenerative offspring for a crime, or to let them starve for the imbecility, society can prevent those who are manifestly unfit from continuing their kind.The principle that sanctions compulsory vaccinations is broad enough to cover cutting the Fallopian tubes."

EMPHASIS: Even though forced sterilization laws were overturned or abolished, some Native American women are still concerned about the practice.

Questions:

1. Laws are passed to either encourage or discourage behavior. What do you think was the reasoning for passing the Family Planning Services and Population Research Act? Explain your answer.
2. One area of criticism in the investigation was the lack of paperwork. Would the axiom "If it wasn't written down, it wasn't done!" apply here? Explain your answer.

Court Case 12-2

FACTS: Sharon Duchesneau and Candace McCulloguh are a lesbian couple in a committed relationship. Both of them are deaf and they sought a sperm donor who has a family history of deafness.Sharon and Candace readily admitted that their hope was to have a child with deafness, which they considered an identity and not a disability. Their daughter Jehanne is deaf and their son Gauvan is deaf in one ear and has significant hearing loss in the other.

When news broke about their children, social reaction was swift and highly critical. Reaction from the Traditional Values Coalition called Gauvan a "victim of the homosexual agenda." But other ethicists focused on the "designer baby" approach.

Another objection came from individuals who thought gayness could be "cured" and therefore should be prevented. They further insisted that deafness could be cured with the use of cochlear implants, although the procedure is strongly protested by the deaf community.

ISSUE:Is deafness and homosexuality be something that can or should be changed?

RULE: Neuroscientist Simon LeVay reported that homosexual men have a smaller hypothalamus than straight men do. But LeVay, who is gay, stated that he would respect a parent's choice to have a homosexual child or to avoid having one. "My hope [he said] is that we can create a society where few people will want to do either of these things."

EMPHASIS: Although views have changed over the years, some prejudices against the LGBTQ still remain. While same-sex marriage has been ruled Constitutional by the US Supreme Court, many ultra-conservatives are still trying to get same-sex marriages annulled and laws allowing them revoked.

Questions:

1. What if their desire was not only to have a deaf child but to have a homosexual child? What are your thoughts? Explain your answer.
2. Why do you think more people today are more accepting of the LGBTQ culture? Explain your answer.

Court Case 12-3

FACTS: Lisa McPherson joined the Church of Scientology in 1994 at the age of 18. On November 18, 1995, she was involved in a car accident. While she was initially cleared medically by paramedics, she began to disrobe at the scene of the accident. She was taken to a hospital to be evaluated medically and psychologically. After the initial assessment, it was suggested that she stay for observation. However, members of her church intervened and signed her out of the hospital.

Lisa was taken to a hotel by members of her congregation, where she was subjected to an Introspective Rundown procedure. On December 5, 1995, Lisa was taken to the hospital in critical condition and later died. An autopsy determined that she died from a blood clot in her pulmonary artery which was attributed to bed rest and severe dehydration. The autopsy also showed that she had multiple bruises, abrasions, and lesions consistent with insect bites.

Criminal charges were brought against members of her congregation and church leaders. The charges included the abuse and neglect of a disabled person and the unauthorized practice of medicine. In response, church leaders provided patient care logs that had been written while Lisa was at the hotel, however they admitted that the logs from the three days prior to her death had been shredded.

The Church of Scientology hired their own forensic pathologist to review the autopsy findings. Their pathologist concluded that the blood clot was a result of the car accident and not from bed rest and dehydration, thereby clearing the church of any wrongdoing.

ISSUE:Was the Church of Scientology responsible for Lisa's death or was it due to the car accident?

RULE: After viewing the autopsy report provided by the Church's pathologist, the state's pathologist changed his report, determining that the cause of death was from the accident. As a result, prosecutors did not believe they would be able to prove their case.

Lisa's parents brought a civil lawsuit against the church claiming wrongful death and false imprisonment, but the case was settled out of court with a non-disclosure agreement.

EMPHASIS: Writing about the introspective rundown procedure, L. Ron Hubbard was quoted as saying, "This means the last reason to have psychiatry is gone. I have made a technical breakthrough which possibly ranks with the major discoveries of the Twentieth Century. Its results are nothing short of miraculous."

Questions:

1. Since this case, the Church now requires members and their families to sign a waiver giving up of the right to bring a legal claim against the church before participating in an Introspective Rundown. What do you think about such a waiver? Explain your answer.
2. Why do you think that the State's pathologist changed his original findings? Explain your answer.

Court Case 12-4

FACTS: After collapsing at work, 47-year-old Elmaz Juseinoski was rushed to the hospital. He died after resuscitative measures were unsuccessful. When the Juseinoski family arrived, after learning that he had died, they informed hospital staff that they were Muslim and that the body needed to be taken to a mosque. They were told to return in the morning.

Upon their return, they were informed that Elmaz's body had been taken to the morgue for an autopsy. The family sued, alleging that the hospital knew they were Muslim and had failed to inform them that an autopsy would be performed. In addition, they sued for the intentional infliction of emotional distress.

ISSUE:Because of religious implications, is there a duty for healthcare providers to know and understand different religious beliefs?

RULE: Citing New York Public Health Law 42114(1) honoring religious objections to autopsies, ruled in favor of Elmaz's family.

EMPHASIS: In this case, the cause of death was not associated with a crime. While Muslims will allow autopsies if legally required, they argued that in this case it was not. This case demonstrates the importance and the wide variety of religious beliefs as they relate to healthcare.

Questions:

1. Because Elmaz was 47-years old, do you think there was a medical reason for the autopsy? Explain your answer.
2. We didn't go over the Intentional Infliction of Emotional Distress. But do some research and see if you can come up with a definition.