In 2011, Rinat Dray went to Staten Island Hospital, already in labor. She had already had two babies through C-sections and had her mind set on giving birth naturally. But she said the doctor immediately started persuading her to have a C-section. In 2014 she sued the hospital for malpractice, among other claims, saying that the doctors did not care about her judgment as a mother, but pressured and threatened her. The hospital claimed it had followed its “Managing Maternal Refusals” policy–a policy for how to deal with mentally competent mothers when they refuse the medical decisions the doctors recommend. The case was heavily covered in the media, but the court did not agree with most of her claims. Now, she’s appealing the case, and the New York City Bar Association has filed an amicus brief in support of Dray.

The new brief argues that New York state law requires hospitals to give patients access to adequate information beforehand, so they can make informed decisions about their own health care. The hospital allegedly never told Dray about the “Maternal Refusals” policy or what choices she had. Also, as the brief notes, it’s against New York law to force patients to undergo care they have not consented to. C-sections are also significantly more likely to cause health problems both for the mother and the baby than natural childbirth. In Dray’s case, her bladder was cut during surgery.

That day at the hospital in 2014, the doctor reportedly told Dray that unless she had a C-section, her uterus would rupture and the baby would be endangered. The doctor claimed that this would be equal to child abuse and her baby would be taken from her. The medical team tried to deliver the baby naturally for hours, before they decided to take Dray to an operating room and perform the surgery despite her protests. The hospital does not deny this–a note in the record for Dray’s delivery, written by the hospital’s director of maternal medicine, said “I have decided to override her refusal to have a C-section,” and that Dray’s doctor and the hospital lawyer agreed with him. Later Dr. Leonid Gorelik claimed that any injuries the mother suffered were due to her own “culpable conduct and want of care.”

We have been proud to support Rinat Dray in her efforts to seek justice after being subjected to cesarean surgery… https://t.co/Ul0iu4M42M

— NAPW (@NAPW) November 23, 2015

According to the American Congress of Obstetricians and Gynecologists ethics committee, pregnancy doesn’t make a woman exempt from the right to make her own decisions. It says, “the use of coercion is not only ethically impermissible but also medically inadvisable because of the realities of prognostic uncertainty and the limitations of medical knowledge.” ACOG adds that it discourages medical providers in the strongest possible terms from trying to coerce a patient into a medical decision, and that includes “threats to involve the courts or child protective services, to motivate women toward a specific clinical decision.”

And in most cases, the judicial system agrees that an individual should have the right to make decisions about one’s own medical care. According to attorney Farah Diaz-Tello, there is no law that says that “pregnant women lose this right upon becoming pregnant.” The hospital would likely need a court order to go ahead and use the procedure against the mother’s will. But in some cases, courts have actually sided with the hospital. National Advocates for Pregnant Women has recorded 30 cases where a court order has been used to force a woman to accept a C-section between 1973 and 2005.

But putting the rights of an unborn fetus above those of the mother creates a scary situation for women. The NAPW says that authorities have often used legal measures to limit women’s physical liberties. There was a case where a woman who delayed having a C-section was charged with murder because one of her twin babies was stillborn. Women have been charged with child endangerment for doing drugs while pregnant, and there have been multiple arrests of women who have had abortions or even miscarriages.

The NYC Bar Association’s brief concludes that in failing to inform Dray about the hospital’s written policy, it took away her opportunity to choose another hospital, which is a violation of her rights under New York law and the U.S. Constitution. We’ll have to see how Dray’s case does on appeal.

Emma Von Zeipel

Emma Von Zeipel is a staff writer at Law Street Media. She is originally from one of the islands of Stockholm, Sweden. After working for Democratic Voice of Burma in Thailand, she ended up in New York City. She has a BA in journalism from Stockholm University and is passionate about human rights, good books, horses, and European chocolate. Contact Emma at EVonZeipel@LawStreetMedia.com.

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New Jerseyans might wonder why they’re suddenly seeing billboards featuring a pleading dog, next to the text “Don’t kill man’s best friend for medical testing.” It’s part of a Washington D.C. based physicians’ non-profit’s new campaign, targeting the Morristown Hospital in New Jersey for practicing surgery on live dogs that are euthanized after the session. The Physicians Committee for Responsible Medicine has posted billboards near the Morristown train station and is planning one along the highway as well.

 The group writes on its website:

At Morristown Medical Center in New Jersey, emergency medicine residents are taught procedural skills using live dogs. Trainees are instructed to make incisions, insert a tube into a dog’s chest cavity, crack open the breastbone in order to access the heart, and insert or drill a needle into the animal’s bones. At the end of each training session, the animals are killed,

The group claims this procedure is at odds with today’s standards of practice. Out of 200 similar programs in the country, the group has surveyed 160 hospitals. Reportedly, 89 percent of surveyed emergency medicine programs use non-animal methods to practice operations, such as human body simulators or cadavers, which allow medical students to make mistakes and learn at their own pace, without it ending with an injured or dead animal.

NJ Hospital using live dogs to train surgical residents! Where is @peta ? https://t.co/w7fIVltWYJ pic.twitter.com/jb8JWRikhn

— Johnny Rivera (@prjohnnyrivera) November 17, 2016

The physician’s group was founded in 1985 and lobbies to end all kinds of animal testing. John Pippin, the group’s director of academic affairs, said that Morristown is the only hospital that reported it uses dogs for its residency training program. The few others that still use live animals typically use pigs instead, a less controversial practice.

But Morristown Hospital’s spokeswoman, Elaine Andrecovich, defended the practice. She said it is an essential way for emergency medicine doctors to practice crucial skills that they can’t learn through simulation or through training devices. According to Andrecovich, the dogs are only used when preparing for “rare, life-saving procedures uncommonly seen” in actual life. She also pointed out that simulators couldn’t compete with “the physiological or anatomical equivalent of live tissue.”

The hospital has not revealed where it performs the procedures on the dogs, only that it is not at the hospital or its property.

Emma Von Zeipel

Emma Von Zeipel is a staff writer at Law Street Media. She is originally from one of the islands of Stockholm, Sweden. After working for Democratic Voice of Burma in Thailand, she ended up in New York City. She has a BA in journalism from Stockholm University and is passionate about human rights, good books, horses, and European chocolate. Contact Emma at EVonZeipel@LawStreetMedia.com.

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Picture this: you wake up in the middle of the night with insane abdominal pain and call 911 to be rushed to the hospital immediately. Once you get there, the doctors decide you are suffering from acute appendicitis and you have to quickly be prepared for an emergency surgery to remove your appendix. Before you’re put under anesthesia, you notice the nurse prepping you is stumbling around, tripping over chords, and is seemingly having a hard time doing average tasks. Worried yet?

This exact scenario unfolded earlier this month at the Wilkes-Barre VA Medical Center, for which a nurse has been charged with reckless endangerment of a patient’s safety, driving under the influence, and public intoxication for showing up to work and then proceeding to work on an appendectomy while drunk.

The story, according to the drunk nurse, Richard Pieri, was that he had forgotten that he was on call at the hospital on February 4 until he received a call around midnight telling him to come into work on an emergency surgery. At that point, Pieri was already four or five beers deep at a local casino, but still decided it would be better to drive while intoxicated to the hospital and work on this surgery than it would be to acknowledge his mistake. In court documents, Pieri acknowledged that he just didn’t want someone else to have to come in while he was supposed to be on call. That is why he decided drunk surgery was a good plan–a great reminder to us all that alcohol can seriously inhibit good decision-making skills. Authorities later visited Piere and asked him if he knew why they were there to chat with him, Pieri nonchalantly responded, “I guess it has something to do with me being drunk on call.”

The Department of Veterans Affairs sent a statement to the Washington Post noting that it will not tolerate behavior like this, especially since it can put veterans who are coming in for care at serious risk. The VA is currently working on reinforcing its guidelines for staff and ensuring that an incident like this never happens again. Pieri’s affidavit notes that he was tasked with prep work that was legitimately important:

[He] was responsible for preparing the patient, retrieving the patient, preparing the materials inside the room, documenting the surgery, and monitoring the vitals of the patient throughout recovery.

In addition, the affidavit pointed out that the operating room, in general, can be dangerous if someone is intoxicated:

[The operating room] is filled with complicated equipment that Pieri needs to operate and has several loose wires and cords that can be tripped on or disconnected by somebody with an inability to properly ambulate themselves.

While details about the patient have not yet been released, reports indicate that he or she was readmitted to the hospital after the surgery for complaints of stomach pains. There is no evidence to suggest that this readmission has anything to do with Pieri’s drunkenness–thank goodness–but he was promptly removed from patient care responsibilities after this incident.

While this story turned out alright (for the most part), it’s a sobering reminder to us all that alcohol can have serious consequences in certain situations. Just because you think you’re alright to drive home, make a large purchase, or even perform a serious medical procedure, doesn’t mean you are. So, think carefully about when and where you drink and make responsible decisions everyone, because no one wants to be that guy who was jokingly asked, “Rick, are you drunk?” after he stumbled into work.

Alexandra Simone

Alex Simone is an Editorial Senior Fellow at Law Street and a student at The George Washington University, studying Political Science. She is passionate about law and government, but also enjoys the finer things in life like watching crime dramas and enjoying a nice DC brunch. Contact Alex at ASimone@LawStreetmedia.com

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ICYMI, check out this week’s best articles from Law Street, including ridiculous LSAT anecdotes, shocking news out of Egypt’s hospitals, and how you can be fired for legally smoking weed.

#1 The Most Ridiculous LSAT Stories of the Year

The June 2015 LSAT is over, and approximately 20,000 people are eagerly–or anxiously, depending on how they did–waiting on their results. In the meantime, users of law school forums like Top Law School (TLS) and PowerScore have created post-test impressions and waiter’s threads to pass the time. Read full article here.

#2 The Sad State of Egypt’s Hospitals: Shocking Pictures Released

Doctors need the proper resources to be able to treat their patients. But a new viral Facebook page started in Egypt illustrates that doctors and dentists in that country don’t necessarily have access to what they need. The page is shocking to many, as photos of multiple hospitals in Cairo, Egypt have been shared illustrating that they are unequipped and unsanitary for doctors to properly operate in. Read full article here.

#3 Can You Be Fired For Legal Marijuana Use?

In Colorado and thinking about smoking marijuana after work? Might want to reconsider that. Even though many Colorado residents qualify to use medical marijuana regularly, it can carry many consequences for consumers. In a landmark Colorado Supreme Court decision, Coats v. Dish Network, the court decided that employers can now lawfully terminate employees for using medical marijuana, even if they are off the clock. Read full article here.

Chelsey D. Goff

Chelsey D. Goff was formerly Chief People Officer at Law Street. She is a Granite State Native who holds a Master of Public Policy in Urban Policy from the George Washington University. She’s passionate about social justice issues, politics — especially those in First in the Nation New Hampshire — and all things Bravo. Contact Chelsey at staff@LawStreetMedia.com.

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One hospital’s trash is another man’s amputated leg. Or at least this was the case for 56-year-old John Timiriasieff.

Timiriasieff went to the Doctor’s Hospital in Coral Gables, Florida last October to have his leg amputated below the knee. This, as we can all imagine, was not a pleasant experience for the man.

However, to make matters worse, Timiriasieff received a knock on the door and was shocked to find homicide detectives there asking about foul play. You see, likely in an attempt to save fuel or prevent a forest fire, the hospital had apparently decided it was going to skip the incineration of the limb as would have occurred after most amputations, at least at other hospitals. Instead, it decided to take a much simpler approach: just throw out the leg.

Now, some advice for anyone who is going to be throwing out body parts in the future: when you throw away a human part, remember to remove the name tag before you do so. Otherwise, you will get caught a lot more quickly.

That is what happened here. The leg was found in a waste management facility where the shocked finder (at least I assume someone who just found a leg in the trash was shocked, though, honestly, I don’t know. Maybe they find weird items and body parts there a lot. This is, after all, Florida) swiftly reported it to the police.

The police investigation was made easy by the fact that the leg was labelled already. They didn’t need DNA testing as long as someone on the force knew how to read. Thus, they showed up on Timiriasieff’s doorstep shortly after he had already gone through emotional upheaval, wanting to know if there had been foul play.

Courtesy of Giphy.

Imagine you had to get rid of something you love. You go through the five states of grief. You deny it is happening. You get mad that it is happening to you. You bargain for any other situation. You mourn the truth. But finally, you accept that it has to be that way and you separate yourself from that thing that means so much to you – in this case, quite literally. Then, after you have finally accepted that it is gone, it shows up at your front door mocking you for your efforts. Would you be emotionally distraught?

Timiriasieff was. Or he said he was at any rate. And for this reason, he has decided to sue the hospital for emotional distress. To win, he needs the court to determine that intentionally throwing someone’s leg in the trash was outrageous conduct and that it actually caused emotional distress. Do you think he has a case? Or was the conduct not outrageous enough?

Ashley Shaw

Ashley Shaw is an Alabama native and current New Jersey resident. A graduate of both Kennesaw State University and Thomas Goode Jones School of Law, she spends her free time reading, writing, boxing, horseback riding, playing trivia, flying helicopters, playing sports, and a whole lot else. So maybe she has too much spare time. Contact Ashley at staff@LawStreetMedia.com.

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College alone these days is very expensive. Now, add grad school on to that, and I don’t care what you are going to make in the profession in which you were just trained, you are going to be in a whole lot of debt when you get out of school. Then, you have to go through the whole resume, interview process. And let’s face it, that is no fun. Which is why I think the teenager in the following story has the right idea: just skip the schooling portion of job placement. And while you are at it, just skip through the whole application process too. How do you do that? Just show up to the place you want to work, and blend in. Probably no one will ask you if you are supposed to be there.

Courtesy of Giphy.

To learn more, let’s examine St. Mary’s Medical Center in, of course, Florida–because that is where all these stories happen. A young doctor was recently escorted out of the building by security because, well he wasn’t actually a doctor so much as a teenage boy wearing a doctor’s coat.

Ok. Well, he tried and didn’t succeed. The way security is these days and the importance of safe hospitals means you couldn’t get away with such a scam for very long.  I mean, like in this story, the kid only got away with posing as a doctor for about 20 or 30…days. That is right. A month.

To be fair to the hospital, he didn’t actually work with patients in his month on staff. In fact, it was when he stepped up his game and actually went into an exam room, with a stethoscope around his neck and a mask on his face, and introduced himself as Doctor Robinson (and didn’t follow it with “I’m not a doctor, I only play one on TV”), that he got caught.

One of the real doctors noticed him and thought something wasn’t right. So he called security, who was surprised that the kid was faking it–as they had seen him around the last few weeks and thought he belonged there.

Here is the thing about this story that makes me feel a little bad about making fun of it: the kid, according to his mother, had an illness for which he had stopped taking medication. And I cannot joke about that. However, here is the part that make me feel perfectly fine joking about it: we know the kid’s excuse for doing this. What was the hospital’s excuse for not catching this kid faster? That I can make fun of.  And that is probably a big part of why the center will not be pressing charges.

This story has been told far and wide, and there is a good chance you have already heard about it. So you might be asking yourself just why I didn’t make that one obvious connection that everyone is making. And I will tell you why. Because everyone is making it, and I want to be a little more unique than that. So I will not say a word. I’ll just leave you with this picture, which will say a thousand words for me:

Courtesy of FanPop.

Ashley Shaw

Ashley Shaw is an Alabama native and current New Jersey resident. A graduate of both Kennesaw State University and Thomas Goode Jones School of Law, she spends her free time reading, writing, boxing, horseback riding, playing trivia, flying helicopters, playing sports, and a whole lot else. So maybe she has too much spare time. Contact Ashley at staff@LawStreetMedia.com.

The post Doctor Who? Teen Tricks Hospital For an Entire Month appeared first on Law Street.

Health care costs have long been a hot topic of conversation in American culture. We’ve had problems with our health care system because the costs are high, of course, but also because sometimes they’re simply unknown. Often people who go in for a procedure, even with insurance, have no idea how much they’re going to owe until they receive a bill in the mail. One state has finally decided that that’s a bad way of doing things–starting this month, the state of Massachusetts is providing “price tags” for healthcare.

As of last week, if you are insured through a private company, you can go on that company’s website, type in what medical procedure you’re looking to get, and it will tell you how much it costs. This is part of an act that Massachusetts passed in 2012 that aimed to create greater transparency in healthcare costs, and make the system more efficient.

Now this system isn’t perfect, nor is it centralized. Not every single cost associated with a particular medical procedure will be listed–for example some places won’t list the cost of reading a scan or processing a test or an accompanying hospital stay.

The WBUR reporter who checked out the system, Martha Bebinger, also noticed some other interesting components. Health care costs vary by hospital or doctor, as well as by insurance provider. In some cases the difference was negligible, but in others, it was striking. For example, the cost of an Upper Back MRI ranges from around $600 to $1800, depending on where you go. Bebinger also noticed that the costs can change from day to day.

This is a valuable tool, because in addition to allowing patients to figure out where would be the best place to get a particular procedure, it also allows them to plan ahead. Some of the sites also create calculations of co-pays and the like, making the sites even more budget-planner friendly. Some of the sites allow the ability to leave patient reviews, so people can get some idea of the quality of the healthcare they will get before they actually commit. And while the system is by no means centralized, all of the big insurance providers in Massachusetts seem to have created some sort of online site with the ability to price-check.

The new requirements have also been applauded because of the hope that they may drive healthcare prices down. If people are able to readily access prices, they will shop around, and private doctors may offer slightly lower prices to incentivize customers.

The only possible concern I see is that people may be discouraged from going to the doctor’s office if they know in advance how much it will cost. However, I would imagine that those cases would be few and far between, and that overall, more transparency will benefit people who are on a budget.

Massachusetts has, in the past, introduced innovations in its health care system that ended up becoming national trends–the Affordable Care Act was loosely based on Massachusetts’s system of healthcare. Massachusetts may once again be in the position of testing an idea that could eventually end up a national norm.

Anneliese Mahoney

Anneliese Mahoney is Managing Editor at Law Street and a Connecticut transplant to Washington D.C. She has a Bachelor’s degree in International Affairs from the George Washington University, and a passion for law, politics, and social issues. Contact Anneliese at amahoney@LawStreetMedia.com.

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For the first time in the United States during the current outbreak, a patient was diagnosed with the Ebola virus–the Centers for Disease control confirmed the case on Tuesday. As if Thomas Duncan, the infected Liberian man who came to the United States, doesn’t have enough to worry about, he’s also facing legal trouble. The Liberian government will prosecute Duncan when he returns to Liberia for allegedly lying on an airport questionnaire, the Associated Press reported.

Duncan left Liberia on September 19th to visit his family and wasn’t showing any symptoms at the time. Days before, he helped take a 19-year-old infected pregnant woman to a hospital and helped bring her back home when she was turned away for lack of space, the New York Times reported. The woman, Marthalene Williams, died the next day. Williams’ parents said that Duncan helped carry her back from the taxi to her house. Her brother, who accompanied her, her father, and Duncan on the taxi ride home, also started showing symptoms of Ebola and died less than a week later.

When Duncan was at the airport on his way out of Liberia, he received a questionnaire given to anyone intending to depart Liberia, Guinea, and Sierra Leone – the three West African countries countries most severely facing the Ebola epidemic – asking him about his recent contact history in the country. Duncan answered “no” when when asked whether he had been in contact with anyone who may have been infected.

Duncan passed the screening at the airport without showing any sign of symptoms and boarded his plane. The idea that Liberian officials would threaten to prosecute him might suggest double standards, since people are still able to move between countries in West Africa. But Liberia may have chosen to do this to make an example out of Duncan. It’s likely that Liberia wants to set a precedent that its screenings are serious business and wants countries to where Liberians travel to be reassured about that, Cornell University Law professor Jens Ohlin told the Atlantic.

The sudden decision to prosecute an infected person might also be an attempt not to upset U.S. officials, though Ohlin doesn’t seem to think so. This hasn’t happened in other major countries, so it is tough to say whether Liberia is singling out the United States.

Duncan is arguably very lucky that he happened to be in America when he started to show symptoms of Ebola. The average death rate has been up to 90 percent in previous outbreaks, according to the World Health Organization. But in August, two American aid workers who were working in West Africa were cured of the disease after being treated in Atlanta.

Currently being treated in a Dallas hospital, Duncan started showing symptoms on Sept. 24 and went in for treatment two days later. His family members in Dallas have also been quarantined in their apartment. While the situation is dire in West Africa, CDC Director guaranteed that it wouldn’t be a problem in the United States. “The United States has a strong health care system and public health professionals who will make sure this case does not threaten our communities,” he said in a press release on Tuesday.

—

Zaid Shoorbajee (@ZBajee)

Featured image courtesy of [Phil Moyer via Flickr]

Zaid Shoorbajee

Zaid Shoorbajee is a an undergraduate student at The George Washington University majoring in journalism and economics. He is from the Washington, D.C. area and likes reading and writing about international affairs, politics, business and technology (especially when they intersect). Contact Zaid at staff@LawStreetMedia.com.

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