A case now being briefed to the U.S. Court of Appeals for the Sixth Circuit raises critical issues about how terminal illness is determined for hospice eligibility. (In Home Health v. Kennedy, No. 25-3542). An ALJ rejected over 100 claims by a Toledo, Ohio hospice. But the hospice and its professional society amici argue that the ALJ lacked sufficient basis to reject their claims and deny payment. The case focuses on the appropriate standard of review. The hospice and professional societies argue that there is significant "imprecision of terminal illness prognostication." Therefore, ALJs must defer to physician determinations unless they have "clear and objective evidence" that the determination is inaccurate.  Not only is this approach consistent with Medicare law but it is also good policy. If ALJs can too easily deny claims, physicians will be chilled and deterred from qualifying patients for hospice. 

I recently published on how we procure organs from unrepresented patients. To illustrate my points, I pointed to some ongoing New York litigation alleging that the hospital failed to undertake reasonable efforts to identify the patient and contact the family. In other words, the hospital was erroneous and negligent in determining that its patient was unrepresented.  For the past few months, a similar case has been proceeding in Sacramento, California. On November 2, 2023, Tonya Walker died at Dignity Health's Mercy General Hospital. She was homeless and her family did not know where she was.   In their 2025 lawsuit, the family alleges that the hospital failed to "take any action to notify" them or to seek their authorization for donating Walker's organs. Instead, the hospital authorized donation as if the family were non-existent or unavailable. 

The European Association of Centres for Medical Ethics conference will be Leuven, Belgium from September 24-26, 2026.  Abstracts are open here. The organizers accept all topics related to the field of medical ethics and bioethics in the broad sense. They hope this thematic inclusiveness will encourage young researchers to bring their creativity and diverse perspectives to the conversation.

Lashanna Williams from A Scared Passing discusses VSED in this 2-hour webinar. Unlike my own VSED presentations which summarize published studies and offer legal and ethical analysis, Lashanna shares practical advice on how the patient and family should proceed.  Lashanna knows this stuff well. She has supported many VSED patients at Asphodel House, a safe location to exercise your MAID or VSED end-of-life choice.

A case now being briefed to the U.S. Court of Appeals for the Sixth Circuit raises critical issues about how terminal illness is determined for hospice eligibility. (In Home Health v. Kennedy, No. 25-3542). An ALJ rejected over 100 claims by a Toledo, Ohio hospice. But the hospice and its professional society amici argue that the ALJ lacked sufficient basis to reject their claims and deny payment. The case focuses on the appropriate standard of review. The hospice and professional societies argue that there is significant "imprecision of terminal illness prognostication." Therefore, ALJs must defer to physician determinations unless they have "clear and objective evidence" that the determination is inaccurate.  Not only is this approach consistent with Medicare law but it is also good policy. If ALJs can too easily deny claims, physicians will be chilled and deterred from qualifying patients for hospice. 

The U.S. Court of Appeals for the Fifth Circuit has just certified this question to the Supreme Court of Mississippi: Does Mississippi’s Uniform Health-Care Decisions Act require health care providers, in the absence of a designated surrogate, to identify qualifying family members and ensure that no such family member with higher priority is reasonably available under the circumstances before relying on a health care decision made by a lower-priority family member?   Mark Anthony Stanford was a resident at Brandon Nursing and Rehabilitation Center when he was injured by a fire. When he sued Brandon, it argued that Stanford was bound by an arbitration agreement signed by his default surrogate, his brother. But Stanford argues the arbitration is invalid because his brother lacked authority to sign it. The U.S. District Court for the Southern District of Mississippi agreed. Stanford's brother lacked authority because Stanford's son was reasonably available. Because children are in a higher class than siblings, Stanford argues that Brandon should have looked to his son rather than to his brother as surrogate. While the case focuses on Mississippi law, that law was adapted from the UHCDA. And it is similar to most state health care decisions statutes across the country. 

If you are not yet registered for ICEL5, early bird registration ends November 30, 2025. The International Conference on Assisted Dying and Other End of Life Care has expert speakers on MAID/VAD from Belgium, Canada, Australia, New Zealand, Spain, the Netherlands, and more than a dozen other jurisdictions new and old to MAID/VAD. ICEL5 also has a robust stream on VSED, including me and four other author teams. And while the overwhelming focus is on MAID/VAD, there are streams on other end-of-life care issues too.

Clinicians at the University of Rochester resuscitated Donald Tuohey contrary to his MOLST. His family successfully litigated a medical malpractice action against the hospital, resulting in a jury verdict for money damages.  This week, the Appellate Division reversed that judgment because the plaintiffs' expert witnesses failed to introduce evidence on standard of care. Consequently, the jury had no basis to find breach. But the court rejected a range of other defense arguments. Specifically, the court ruled that plaintiffs could sue for medical malpractice as opposed to “wrongful life.” Plaintiffs do not need an "explicit statute creating a private cause of action for the violation of a MOLST." Furthermore, the court rejected the argument that "there can be no cause of action for violating a MOLST in an emergency situation." And the court rejected a claim of statutory immunity. In short, while the plaintiffs lost this case on appeal, that was because of the evidence presented at trial. The law is clearly on their side and the side of other patients with advance directives and POLSTs.

I recently published on how we procure organs from unrepresented patients. To illustrate my points, I pointed to some ongoing New York litigation alleging that the hospital failed to undertake reasonable efforts to identify the patient and contact the family. In other words, the hospital was erroneous and negligent in determining that its patient was unrepresented.  For the past few months, a similar case has been proceeding in Sacramento, California. On November 2, 2023, Tonya Walker died at Dignity Health's Mercy General Hospital. She was homeless and her family did not know where she was.   In their 2025 lawsuit, the family alleges that the hospital failed to "take any action to notify" them or to seek their authorization for donating Walker's organs. Instead, the hospital authorized donation as if the family were non-existent or unavailable. 

The theme for the Society of Christian Bioethics Annual Conference is The End of Life, the Gift of Life: Reflections on Death and Organ Donation. The meeting will be online from February 20-22, 2026. Topics relating to the conference theme include:  * Dead Donor Rule and its ethical implications  * Moral and theological considerations of death criteria (e.g., brain death, circulatory death) * Issues of justice and equity in organ allocation and distribution * Role of faith and conscience in end-of-life decisions and organ donation * Ethical challenges of xenotransplantation * Nature and harms of death and dying * Animal ethics as it relates to xenotransplantation * Use of new technologies in organ preservation and transplantation * Pastoral and spiritual care for donor families and transplant recipients * Historical perspectives on Christian engagement with death and bodily integrity * Normothermic Regional Perfusion

The U.S. Court of Appeals for the Fifth Circuit has just certified this question to the Supreme Court of Mississippi: Does Mississippi’s Uniform Health-Care Decisions Act require health care providers, in the absence of a designated surrogate, to identify qualifying family members and ensure that no such family member with higher priority is reasonably available under the circumstances before relying on a health care decision made by a lower-priority family member?   Mark Anthony Stanford was a resident at Brandon Nursing and Rehabilitation Center when he was injured by a fire. When he sued Brandon, it argued that Stanford was bound by an arbitration agreement signed by his default surrogate, his brother. But Stanford argues the arbitration is invalid because his brother lacked authority to sign it. The U.S. District Court for the Southern District of Mississippi agreed. Stanford's brother lacked authority because Stanford's son was reasonably available. Because children are in a higher class than siblings, Stanford argues that Brandon should have looked to his son rather than to his brother as surrogate. While the case focuses on Mississippi law, that law was adapted from the UHCDA. And it is similar to most state health care decisions statutes across the country. 

If you are not yet registered for ICEL5, early bird registration ends November 30, 2025. The International Conference on Assisted Dying and Other End of Life Care has expert speakers on MAID/VAD from Belgium, Canada, Australia, New Zealand, Spain, the Netherlands, and more than a dozen other jurisdictions new and old to MAID/VAD. ICEL5 also has a robust stream on VSED, including me and four other author teams. And while the overwhelming focus is on MAID/VAD, there are streams on other end-of-life care issues too.

Lashanna Williams from A Scared Passing discusses VSED in this 2-hour webinar. Unlike my own VSED presentations which summarize published studies and offer legal and ethical analysis, Lashanna shares practical advice on how the patient and family should proceed.  Lashanna knows this stuff well. She has supported many VSED patients at Asphodel House, a safe location to exercise your MAID or VSED end-of-life choice.

I recently published on how we procure organs from unrepresented patients. To illustrate my points, I pointed to some ongoing New York litigation alleging that the hospital failed to undertake reasonable efforts to identify the patient and contact the family. In other words, the hospital was erroneous and negligent in determining that its patient was unrepresented.  For the past few months, a similar case has been proceeding in Sacramento, California. On November 2, 2023, Tonya Walker died at Dignity Health's Mercy General Hospital. She was homeless and her family did not know where she was.   In their 2025 lawsuit, the family alleges that the hospital failed to "take any action to notify" them or to seek their authorization for donating Walker's organs. Instead, the hospital authorized donation as if the family were non-existent or unavailable. 

Since 1995, the Emory Law Journal has hosted the Randolph W. Thrower Symposium—an Emory Law tradition that brings scholars and leaders together to address some of the most pressing legal questions of our time. This year, it includes a panel on Dignity in End-of-Life Decision Making. Two other panels address Public Health, Private Choice and Reimagining Reproductive Rights.  It is a pleasure to participate with such eminent scholars as Nicole Huberfeld, Wendy Parmet, Ani Satz, Lindsay Wiley, Leslie Francis, and Greer Donley.  

Clinicians at the University of Rochester resuscitated Donald Tuohey contrary to his MOLST. His family successfully litigated a medical malpractice action against the hospital, resulting in a jury verdict for money damages.  This week, the Appellate Division reversed that judgment because the plaintiffs' expert witnesses failed to introduce evidence on standard of care. Consequently, the jury had no basis to find breach. But the court rejected a range of other defense arguments. Specifically, the court ruled that plaintiffs could sue for medical malpractice as opposed to “wrongful life.” Plaintiffs do not need an "explicit statute creating a private cause of action for the violation of a MOLST." Furthermore, the court rejected the argument that "there can be no cause of action for violating a MOLST in an emergency situation." And the court rejected a claim of statutory immunity. In short, while the plaintiffs lost this case on appeal, that was because of the evidence presented at trial. The law is clearly on their side and the side of other patients with advance directives and POLSTs.

Lashanna Williams from A Scared Passing discusses VSED in this 2-hour webinar. Unlike my own VSED presentations which summarize published studies and offer legal and ethical analysis, Lashanna shares practical advice on how the patient and family should proceed.  Lashanna knows this stuff well. She has supported many VSED patients at Asphodel House, a safe location to exercise your MAID or VSED end-of-life choice.

The theme for the Society of Christian Bioethics Annual Conference is The End of Life, the Gift of Life: Reflections on Death and Organ Donation. The meeting will be online from February 20-22, 2026. Topics relating to the conference theme include:  * Dead Donor Rule and its ethical implications  * Moral and theological considerations of death criteria (e.g., brain death, circulatory death) * Issues of justice and equity in organ allocation and distribution * Role of faith and conscience in end-of-life decisions and organ donation * Ethical challenges of xenotransplantation * Nature and harms of death and dying * Animal ethics as it relates to xenotransplantation * Use of new technologies in organ preservation and transplantation * Pastoral and spiritual care for donor families and transplant recipients * Historical perspectives on Christian engagement with death and bodily integrity * Normothermic Regional Perfusion

The Annual HEC Conference at Emory University is one of the best regional bioethics conferences in the country. Plan to be in Atlanta or online March 23-24, 2026. 

Clinicians at the University of Rochester resuscitated Donald Tuohey contrary to his MOLST. His family successfully litigated a medical malpractice action against the hospital, resulting in a jury verdict for money damages.  This week, the Appellate Division reversed that judgment because the plaintiffs' expert witnesses failed to introduce evidence on standard of care. Consequently, the jury had no basis to find breach. But the court rejected a range of other defense arguments. Specifically, the court ruled that plaintiffs could sue for medical malpractice as opposed to “wrongful life.” Plaintiffs do not need an "explicit statute creating a private cause of action for the violation of a MOLST." Furthermore, the court rejected the argument that "there can be no cause of action for violating a MOLST in an emergency situation." And the court rejected a claim of statutory immunity. In short, while the plaintiffs lost this case on appeal, that was because of the evidence presented at trial. The law is clearly on their side and the side of other patients with advance directives and POLSTs.

Last week, the United States Conference of Catholic Bishops (USCCB) approved a seventh edition of the Ethical and Religious Directives for Catholic Health Care Services at its November 2025 Plenary Assembly. This edition of the Directives replaces all previous editions. A new Directive #60 addresses VSED -   If a patient expresses an intention to commit suicide by Voluntarily Stopping Eating and Drinking (VSED), he or she should be informed that the Catholic health care service will not facilitate this course of action. Rather, health care professionals should do what they can, in a way that respects the patient’s freedom, to dissuade the patient from this course of action. They should continue to provide appropriate pain management while avoiding immoral cooperation with suicide by VSED. When appropriate, psychiatric care can be recommended. The pastoral care team should be consulted. Appropriate steps should be taken to avoid giving scandal.

The theme for the Society of Christian Bioethics Annual Conference is The End of Life, the Gift of Life: Reflections on Death and Organ Donation. The meeting will be online from February 20-22, 2026. Topics relating to the conference theme include:  * Dead Donor Rule and its ethical implications  * Moral and theological considerations of death criteria (e.g., brain death, circulatory death) * Issues of justice and equity in organ allocation and distribution * Role of faith and conscience in end-of-life decisions and organ donation * Ethical challenges of xenotransplantation * Nature and harms of death and dying * Animal ethics as it relates to xenotransplantation * Use of new technologies in organ preservation and transplantation * Pastoral and spiritual care for donor families and transplant recipients * Historical perspectives on Christian engagement with death and bodily integrity * Normothermic Regional Perfusion

Since 1995, the Emory Law Journal has hosted the Randolph W. Thrower Symposium—an Emory Law tradition that brings scholars and leaders together to address some of the most pressing legal questions of our time. This year, it includes a panel on Dignity in End-of-Life Decision Making. Two other panels address Public Health, Private Choice and Reimagining Reproductive Rights.  It is a pleasure to participate with such eminent scholars as Nicole Huberfeld, Wendy Parmet, Ani Satz, Lindsay Wiley, Leslie Francis, and Greer Donley.  

Alex Schadenberg reports the death of John Kelly. I agree 110% that "John was a gifted orator and incredibly funny and witty." Alex collects a wonderful group of links.  I was fortunate to debate Kelly at the University of Saint Thomas (video), at the National Academy of Medicine (video) and at other places across the country. 

Americans United for Life has again named the best states for end-of-life liberty. These happen to be the states at the bottom of its 2026 "Life List," which ranks states from most to least pro-life based on their existing life-affirming policies. These top 11 states are * Oregon * New Jersey * Vermont * Hawaii * Washington * New York * Massachusetts * Colorado * California * New Mexico * Maine All except Massachusetts have passed a MAID law. The next five states on the list are * Maryland * Rhode Island * Minnesota * Illinois * Delaware Both Illinois and Delaware recently enacted MAID legislation.