An Update on Medical Aid in Dying: Medical, Legal and Ethical Issues

Only available as part of a package

Session Summary: Medical aid in dying (MAID) is allowed in eleven jurisdictions with many additional states considering legislation. PALTmed recently altered its 1997 position (P97) on "assisted suicide" and the issue remains controversial in the medical community. Studies reveal that more patients are likely to request MAID which presents medical, legal and ethical issues. This presentation addresses changes in the law from our last presentation and perspectives from both side of the issue.

Learning Objectives:

  • Explore the physician's discretionary role in counseling and providing MAID to terminally ill patients
  • Define the controversial aspects of MAID with an examination of the pros and cons from a medical, ethical and legal perspective
  • Explore recent court cases that have dealt with the issue of MAID - often with divergent court decisions

Alan Horowitz, Esq., RN

Of Counsel

Arnall Golden Gregory LLP

Alan Horowitz, Esq., RN, is of counsel in the Healthcare practice and a member of the Post-Acute & Long-Term Care team at Arnall Golden Gregory LLP.. He is an innovative healthcare lawyer handling complex regulatory issues concerning Medicare providers such as skilled nursing facilities. Alan serves as vice chair of education for AHLA's Post-Acute and Long-Term Care practice group. Alan also held clinical, faculty and management positions at major medical centers where he utilized his background as a registered respiratory therapist and registered nurse. Alan served as Assistant Regional Counsel at the United States Department of Health and Human Services’ Office of the General Counsel. He worked closely with and litigated cases for the Centers for Medicare and Medicaid Services (CMS) before the HHS Departmental Appeal Board and the federal courts involving enforcement actions taken by CMS. Currently, as counsel to providers, Alan has successfully negotiated and litigated significant cases against CMS. Alan was the Acting Director of ECRI Institute’s National Center for Independent Medical Review and also served as the Director of Clinical and Legal Affairs for the Institute for Safe Medication Practices. Alan also served as in-house counsel and program director for the pilot SNF-based ventilator-dependent program in New Jersey. Alan has co-authored and co-edited the AHLA publication, Post-Acute Care Handbook: Regulatory, Risk and Compliance Issues as well as having written dozens of articles regarding various aspects of health law. Additionally, Alan has been a frequent presenter at national and state forums on topics regarding health law.

Karl Steinberg, MD, CMD, HMDC, HEC-C

Medical Director

Stone Mountain Medical Associates

Dr. Karl Steinberg has been a nursing home, hospice, and home health agency medical director and chief medical officer in the San Diego area since 1995. He received his bachelor’s in biochemistry and molecular biology from Harvard and studied medicine at The Ohio State University College of Medicine, taught high school in New York City for three years, then completed his family medicine residency at University of California San Diego (UCSD) in 1990. He has board certifications in family medicine and in hospice and palliative medicine, and is certified as a nursing home and hospice medical director in addition to having a certification as a healthcare ethics consultant. Dr. Steinberg is a past president of PALTmed (2021-22), CALTCM, and the National POLST Collaborative (2022-24), and past chair of the Coalition for Compassionate Care of California. He serves on the National Advisory Board for the CSU Shiley Haynes Institute for Palliative Care and received the 2022 Doris Howell MD Award for Excellence in Palliative Care. Dr. Steinberg serves on the Board of Directors of the San Diego County Medical Society and as a delegate to the AMA and California Medical Association’s House of Delegates, and chairs CMA’s Council on Ethical, Legal and Judicial Affairs (CELJA). He enjoys presenting at educational conferences to professional audiences and the public, and also serves as a testifying expert winess in civil lawsuits and regulatory matters. Dr. Steinberg is perhaps best known for taking his poodles on patient care rounds with him for three decades.

Peter Jaggard, MD CMD FACP MA

Medical Director

Presbyterian Living IL

Peter Jaggard, MD CMD FACP MA, is a Medical Director at a CCRC in suburban Chicago. He is Board Certified in Internal Medicine and Geriatrics with more than 41 years of practice experience in primary care and PALTC settings. He is a former Chair of the AMDA-SPALTC Ethics Subcommittee. He has written and spoken on a variety of ethical issues in PALTC medicine both at AMDA-SPALTC conferences as well as Bioethics conferences with interdisciplinary audiences. He holds a Masters degree from Trinity Evangelical Divinity School with a concentration in Bioethics.
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