Quiz 3 Supplementary Case IRAC Analysis Flashcards
Arato v. Avedon (1993)
Issue: Whether physicians must disclose statistical life expectancy information to patients as part of informed consent.
Rule: Physicians must disclose material information that a reasonable person in the patient’s position would find significant, not necessarily statistical data.
Analysis: Statistical mortality data is inherently unreliable for individuals; disclosure is governed by a reasonableness standard; courts should not mandate specific disclosures as a matter of law.
Conclusion: No bright-line rule requiring disclosure of statistical life expectancy data; adequacy of disclosure is determined by what a reasonable person would consider significant.
In re Guardianship of Theresa Marie Schiavo (2001)
Issue: Whether a court may authorize removing life support when family members disagree, based on evidence of the patient’s wishes.
Rule: Courts may authorize withdrawal of life-sustaining treatment with clear and convincing evidence of what the incapacitated individual would have wanted.
Analysis: Theresa was in a persistent vegetative state with no hope of improvement; the court must act as proxy when family members disagree; clear and convincing evidence of her wishes existed.
Conclusion: Court properly authorized removal of life support based on clear and convincing evidence of Theresa’s wishes, not family preferences.
In the Matter of Baby “K” (1994)
Issue: Whether a hospital can refuse emergency treatment to an anencephalic infant based on medical futility.
Rule: Under EMTALA, hospitals must provide stabilizing treatment for any emergency medical condition, regardless of medical appropriateness concerns.
Analysis: Baby K’s respiratory distress qualified as an emergency condition; EMTALA contains no exception for medically inappropriate treatment; ethical concerns cannot override statutory requirements.
Conclusion: EMTALA required the hospital to provide respiratory support when needed, regardless of the hospital’s medical futility assessment.
Canterbury v. Spence (1972)
Issue: What standard determines a physician’s duty to disclose treatment risks?
Rule: Physicians must disclose risks material to a reasonable patient’s decision, not just what is customary in the profession.
Analysis: Informed consent requires sufficient information for patient decision-making; disclosure should be based on patient information needs rather than professional custom.
Conclusion: Established the “reasonable patient standard,” shifting from physician-centered to patient-centered informed consent, emphasizing patient autonomy.
Thompson v. Nason Hospital (1991)
Issue: Whether hospitals can be directly liable under corporate liability theory.
Rule: Hospitals have direct, non-delegable duties to patients independent of individual provider liability.
Analysis: Hospitals have four key duties: (1) maintaining safe facilities; (2) selecting competent physicians; (3) overseeing practitioners; and (4) establishing adequate policies.
Conclusion: Pennsylvania Supreme Court recognized corporate liability for hospitals, establishing their direct responsibility for patient care quality.
Washington v. Washington Hospital Center (1990)
Issue: Whether a hospital had a duty to provide carbon dioxide monitoring equipment during anesthesia.
Rule: Hospitals must provide equipment meeting the national standard of care for their type of facility.
Analysis: Evidence showed carbon dioxide monitors were becoming standard by 1987 through expert testimony, professional standards, and the hospital’s own department chair’s testimony.
Conclusion: Standard of care required carbon dioxide monitors by November 1987, based on what was reasonably prudent given available technology, not merely common practice.
Darling v. Charleston Community Memorial Hospital (1965)
Issue: Whether hospitals have duties beyond providing facilities and whether they can be liable for failing to supervise physician care.
Rule: Hospitals have a direct duty to monitor and supervise treatment, informed by regulations, accreditation standards, and bylaws.
Analysis: Modern hospitals do more than furnish facilities; regulations and standards can establish care standards; custom alone should not determine standard of care.
Conclusion: Established hospital corporate liability, recognizing hospitals’ duty to supervise care and intervene when physicians provide inadequate treatment.
Washington v. Glucksberg (1997)
Issue: Does Washington’s prohibition on assisted suicide violate the Due Process Clause of the 14th Amendment?
Rule: Due Process protects fundamental rights “deeply rooted in history” and “implicit in ordered liberty.” Non-fundamental rights need only rational basis review.
Analysis: Anglo-American law has historically prohibited assisted suicide; the claimed right lacks historical support; Washington demonstrated legitimate interests (preserving life, preventing suicide, protecting medical ethics, safeguarding vulnerable groups); these interests rationally relate to the ban.
Conclusion: Washington’s prohibition on assisted suicide is constitutional. Assisted suicide is not a fundamental right, and the ban is rationally related to legitimate state interests.
Vacco v. Quill (1997)
Issue: Does New York’s ban on assisted suicide violate Equal Protection when the state permits refusing life-sustaining treatment?
Rule: Equal Protection requires treating like cases alike. Classifications not affecting fundamental rights or suspect classes need only rational basis.
Analysis: Legal distinction exists between refusing treatment (where disease causes death) and taking lethal medication (where drugs cause death); withdrawal of treatment intends to respect patient wishes while assisted suicide intends death; medical ethics and law recognize this distinction.
Conclusion: New York’s prohibition on assisted suicide doesn’t violate Equal Protection. The distinction between allowing treatment refusal and prohibiting assisted suicide is rational and supported by principles of causation and intent.
Jacobson v. Massachusetts (1905)
Issue: Does a mandatory vaccination law violate the 14th Amendment’s liberty protections?
Rule: States may exercise police power to enact reasonable public health regulations. Constitutional liberty isn’t an absolute right to be free from all restraint.
Analysis: States retain sovereign police powers to protect public health; individual liberty must be balanced against community welfare; the vaccination requirement was reasonable (based on medical evidence, applied when necessary); courts should defer to legislatures in public health matters.
Conclusion: The mandatory vaccination law is a legitimate exercise of state police power. Individual liberty isn’t absolute when facing serious public health threats.
NFIB v. OSHA (2022)
Issue: Did OSHA exceed its authority by mandating COVID-19 vaccination/testing for employers with 100+ employees?
Rule: Agencies possess only powers granted by Congress. The “major questions doctrine” requires clear congressional authorization for significant policy decisions.
Analysis: OSHA regulates occupational, not general public health; the mandate affected 84 million workers—an unprecedented exercise requiring clear authorization; COVID-19 is primarily a general rather than occupational hazard; the mandate applied indiscriminately across industries; Congress hadn’t authorized such action despite other COVID legislation.
Conclusion: OSHA exceeded its statutory authority. The agency can set workplace safety standards but not broad public health measures without clear congressional authorization.
Litowitz v. Litowitz (2000)
Issue: Who should be awarded custody of cryopreserved preembryos in a divorce when one spouse (husband) is the genetic contributor but both spouses signed contracts regarding the preembryos as “intended parents”?
Rule: (1) Express contracts between progenitors regarding preembryo disposition should generally be enforced; (2) Without an express agreement, courts must consider constitutional rights; (3) Individuals have a constitutional right to control their genetic material and reproductive choices.
Analysis: The court found no express agreement determining preembryo disposition upon divorce. The egg donor contract gave the “intended parents” (both spouses) authority over the eggs, but did not address preembryos specifically. The IVF consent only stated that mutual consent was required for disposition decisions, or parties must petition the court. The husband, as the only genetic contributor before the court, had a constitutional right to control reproduction and avoid unwanted parenthood. While the wife wanted the preembryos for implantation in a surrogate, the court determined this would infringe on the husband’s reproductive autonomy, as he did not wish to parent additional children with his ex-wife.
Conclusion: The court awarded the preembryos to the husband, who had contributed genetic material and held constitutionally protected reproductive rights. The court determined that his right not to procreate outweighed the non-genetic wife’s desire to use the preembryos, particularly when there was no express agreement requiring continuation of family planning after divorce.
Dobbs v. Jackson Women’s Health Organization (2022)
Issue: Whether Mississippi’s 15-week abortion ban violates the constitutional right to abortion under Roe and Casey.
Rule: Constitution contains no explicit right to abortion; claimed rights not enumerated must be “deeply rooted in history and tradition” and “implicit in ordered liberty” (Glucksberg test). State regulations on abortion now subject to rational basis review.
Analysis: Majority found no historical protection for abortion in American law when 14th Amendment was ratified (1868), determined Roe/Casey were wrongly decided on multiple grounds (poor reasoning, unworkable standards, weak precedential value), and ruled stare decisis factors favored overruling. Viability standard rejected as arbitrary and ungrounded in history. States’ interest in protecting fetal life sufficient under rational basis review.
Conclusion: Roe and Casey overruled; Constitution doesn’t protect abortion right; authority returns to states; Mississippi’s 15-week ban constitutional as rationally related to legitimate state interest in protecting potential life.
