News in brief - Oct. 11, 2004

Fla. Supreme Court strikes down "Terri's Law" - Further rate reductions in Texas - Calif. medical staff approves settlement with hospital - Meeting explores time of Lewis, Clark - Internal medicine board appoints new vice president - Wyoming makes CME mandatory - Medical schools strengthen conflict-of-interest policies

Fla. Supreme Court strikes down "Terri's Law"

Declaring that it violated the constitutional separation of power between the three branches of government, the Florida Supreme Court voted unanimously to strike down a state law that gave Gov. Jeb Bush the authority to continue medical treatment for Terri Schiavo.

Schiavo, 40, has been in a "persistent vegetative state" since she collapsed 14 years ago when her heart temporarily stopped beating and halted the flow of oxygen to her brain.

Schiavo's husband, Michael, has said she would not have wanted to continue to live in this condition and has worked to have her feeding tube removed. Her parents, however, have insisted that she be kept alive in hope that her condition someday might improve. Courts allowed the tube to be removed in April 2001 and October 2003, only to have others order it reinserted.

After the tube was removed last year, the Legislature passed "Terri's Law," which Bush signed. He immediately ordered the tube to be reinserted six days after it had been removed.

"The continuing vitality of our system of separation of powers precludes the other two branches from nullifying the judicial branch's final orders," the court's opinion states.

"If the Legislature with the assent of the governor can do what was attempted here, the judicial branch would be subordinated to the final directive of other branches. ... No court judgment could ever be considered truly final, and no constitutional right truly secure, because the precedent of this case would hold to the contrary. Vested interests could be stripped away based on popular clamor."

Schiavo had left no documented instructions concerning her wishes for continued medical care, and her case is said to have spurred interest around the country in living wills and advance directives.

Further rate reductions in Texas

Texas Medical Liability Trust in September announced plans to cut doctors' medical liability insurance premiums by 5% Jan. 1, 2005. That is on top of a 12% cut implemented after Texas voters passed a constitutional amendment limiting noneconomic damages awarded in medical malpractice lawsuits to $250,000.

Texas Medical Liability Trust, a physician-owned company created in 1979, writes policies for nearly half of Texas' physicians.

"We have to ask why the other insurers are not following suit," TMA President Bohn D. Allen, MD, said in a statement. "It's time ... other insurers acknowledge the value of Prop 12 and slash their unsupportable rates."

Calif. medical staff approves settlement with hospital

The medical staff at Community Memorial Hospital of San Buenaventura in Ventura, Calif., Sept. 21 voted unanimously to accept bylaw changes in a settlement with the hospital board, said orthopedic surgeon John Hill, MD, medical staff president at Community Memorial Hospital.

The vote finalizes an agreement between the board and medical staff that settles a lawsuit the medical staff filed against the hospital in 2003. Doctors sued after the board adopted policies that took away the medical staff's right to self-govern. Doctors say the agreement gives them the independence they need to do their jobs and lays the groundwork for better communication between the two sides.

At press time, doctors were next waiting for the court to formally dismiss their lawsuit.

Meeting explores time of Lewis, Clark

The Health and Medicine in the Era of Lewis & Clark Conference will be held Nov. 4-6 in Philadelphia.

The conference is open to the public, and most events will be at the College of Physicians of Philadelphia. Many sessions are free. Co-sponsors include the College of Physicians of Philadelphia, the National Library of Medicine and the American Philosophical Society.

Sessions include: climate change and health in early America; medical botany in the American West; and Narratives of Manhood: Exploring the Language of Health and Sickness in the Journals of the Lewis and Clark Expedition. For more information, call 215-563-3737, ext. 305.

Internal medicine board appoints new vice president

The American Board of Internal Medicine has appointed Cary Sennett, MD, PhD, as senior vice president for research and development.

Dr. Sennett will lead the ABIM and ABIM Foundation activities focused on efforts to link certification and maintenance of certification with performance assessment and improvement. His focus will be approaches to reduce redundancy and to enhance the relevance of assessment to the public and the physician community.

Dr. Sennett has worked with several health plans, including US Healthcare, Aetna and Group Health Cooperative of Puget Sound. He served as executive vice president of the National Committee for Quality Assurance. Dr. Sennett is certified in internal medicine.

Wyoming makes CME mandatory

As of Jan. 1, 2007, physicians in Wyoming will have to complete 60 hours of continuing medical education in order to obtain or renew a medical license.

The new requirement established by the Wyoming Board of Medicine also allows for random audits of active license holders to see if they are in compliance. No CME will be required of those maintaining an inactive license.

Some 54 state medical and osteopathic boards require continuing medical education for license registration.

Medical schools strengthen conflict-of-interest policies

Some 95% of allopathic medical schools in the United States now have standards regarding financial conflicts of interest in clinical trials with human subjects, according to a survey by the Assn. of American Medical Colleges.

The survey is a follow-up to a 2001 AAMC report offering medical schools guidelines on how to provide such oversight. A number of deaths of participants in clinical trials sparked the effort to more closely monitor the growing tie between researchers and biotech businesses. These events also prompted the birth of the Assn. for the Accreditation of Human Research Protection Programs.

According to the survey, 95% of responding schools now require researchers to disclose financial interest of $10,000, with 64% requiring disclosure of all equity in nonpublicly traded companies regardless of value along with nonroyalty payments not directly related to the research taking place.

In addition, the survey revealed that 85% require monitoring of the research, 74% require disclosure of a significant financial interest to the participants in the consent form and 76% have established a standing committee on conflicts of interest.