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LAW 805F: Policy Practicum: Endstage Decisions

(Formerly Law 413Z) Medical decisions toward the end of life can be crucial and difficult for patients, doctors, and families. Law and medicine have been struggling to find ways to strike a balance between what the patients might want (or say they want), and what makes medical, economic, and ethical sense. One standard is the "Advanced Health Care Directive" (Directive), which guides doctors and surrogates (usually a family member) on what to do when faced with end-of-life dilemmas. Another form, adopted in just over half the states (including California) is the POLST (Physician Orders for Life-Sustaining Treatment). The two types are supposed to complement each other, but they are different in important ways. The Advanced Health Care Directive expresses what a person wants and/or appoints a surrogate in case the patient is unable to express her wishes. Anybody can fill out a Directive, at any time of life. Ideally, a copy goes to the surrogate, if one is appointed, and another to the primary care physician. The POLST form is meant for people who are seriously ill. The Directive (for example "no artificial nutrition by tube") is supposed to be controlling; the patient, of course, can change her mind; but there is no surrogate. It is an agreement between the patient and the doctor. Who uses these different forms? How effective are they? To what extent and in what situations are they useful? Working closely with Stanford Hospital as the client, students will not only look at current literature on the topic and build on past practicum research, but also conduct interviews with doctors, nurses, and other health care specialists with the goal of finding out what local hospitals and nursing homes are doing. The aim is to get a more realistic picture of the what one might call the living law of the Directive and the POLST. The ultimate goal is policy recommendations to improve the forms and associated laws and to examine alternative approaches. Elements used in grading: Class Participation, Final Paper. -- NOTE: Students may not count more than a combined total of eight units of directed research projects and policy lab practica toward graduation unless the additional counted units are approved in advance by the Petitions Committee. Such approval will be granted only for good cause shown. Even in the case of a successful petition for additional units, a student cannot receive a letter grade for more than eight units of independent research (Policy Lab practicum, Directed Research, Directed Writing, Senior Thesis, and/or Research Track). Any units taken in excess of eight will be graded on a mandatory pass basis. For detailed information, see "Directed Research/Policy Labs" in the SLS Student Handbook. CONSENT APPLICATION: To apply for this course, students must complete and submit a Consent Application Form available on the SLS website (Click Courses at the bottom of the homepage and then click Consent of Instructor Forms). See Consent Application Form for instructions and submission deadline.
Terms: Aut, Win, Spr | Units: 1-3 | Repeatable for credit | Grading: Law Honors/Pass/Restrd Cr/Fail
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