Informed Consent

White hospital bedsSeveral years ago, the Wisconsin veterinary state convention focused on the legal standard of informed consent in the profession. Lawyers explained that this meant that veterinarians needed to provide all options to owners and that owners make the decision as to what options to pursue. Although this seemed simple enough, and certainly some veterinarians already practiced some degree of informed consent, some veterinarians were understandably concerned about discussing a “no treatment” option and some veterinarians practice in situations where discussions with owners may be difficult (e.g., production medicine) or the time involved would defeat the purpose of their services (e.g., high-volume spay/neuter clinics). But the take-home message was that veterinarians are not the responsible parties for making the decisions for clients and that veterinarians need to provide all of the options, and all of the information that clients need to make decisions. Informed consent protects both parties to the transaction.

Informed consent provides transparency. In the veterinary profession, owners are held directly responsible for the decisions and charges incurred. When an owner is informed about diagnostic or treatment options, this includes the cost involved with the options. Informed consent means discussing what the diagnostics or treatments entail, the prognosis or outcome expected, and the costs involved. In fact, most veterinarians provide written estimates for procedures or hospitalization and may require a deposit. Although this may seem insensitive in some way—to require a deposit to provide care—the estimate can be the reality check an owner may need and, again, the owner client is the responsible party.

Informed consent is also the standard in the human medical profession, but the human medical profession does not provide estimates and doesn’t seem to even know, or admit to knowing, what price tag attaches to options. Much is said about the failures of human medicine. Some of this can be attributed to allowing the profession to not be transparent—to not providing information.

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Mental Health, Substance Abuse, and Wellness in the Legal Profession: Change is Necessary

Symbol of a heart with a jagged line representing an EKG printout superimposed over it, in order to represent the concept of "wellbeing"Last week, the American Bar Association (“ABA”) designated and celebrated October 10th, 2018 as National Mental Health Day for Law Schools.[1] This date coincided with the World Mental Health Day.[2] The ABA’s National Mental Health Day for Law Schools serves as a vital reminder that the legal profession is not immune from mental health problems. In fact, the numbers themselves highlight just how important discussing and tackling mental health and wellness are to both law schools and the legal profession in general. Both law students and lawyers suffer in large numbers from mental illness and substance abuse. Therefore, it is important to address these concerns and to help both law students and attorneys live a life that focuses on their wellbeing.

Statistics on Attorneys

In comparison to other professions, lawyers themselves experience higher rates of mental health issues and substance abuse. Attorneys are the most frequently depressed occupational group in the United States, and they are 3.6 times more likely to suffer from depression in comparison to non-lawyers.[3] In a study of roughly 13,000 practicing attorneys conducted by the ABA Commission on Lawyer Assistance Programs and Hazelden Betty Ford Foundation, 28% of the attorneys reported experiencing depression, 23% reported experiencing stress, and 19% reported experiencing anxiety.[4] Of these participants, 21% are qualified as problem drinkers, and they “experience problematic drinking that is hazardous, harmful, or otherwise generally consistent with alcohol use disorders at a rate much higher than other populations.”[5]

This same study found that younger attorneys, rather than older attorneys, are at a greater risk for experiencing these issues.

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Marquette Law Review Article Featured in Prescription Painkiller Exposé

In cooperation with 60 Minutes, the Washington Post has published a fascinating new story about the behind-the-scenes efforts of actors in the pharmaceuticals business to soften regulatory enforcement at the just the time that the nation’s opioid problems were reaching epidemic proportions. The story would be an engaging read for anyone, but Marquette folks may note a particular point of interest: the Post prominently quotes a forthcoming article in the Marquette Law Review.

According to the Post story, the federal Drug Enforcement Administration has long had authority to block suspiciously large shipments of prescription painkillers that pose an imminent danger to the community. In the late years of the Bush Administration and early years of the Obama Administration, the DEA became increasingly aggressive in using this authority to target businesses that were involved in questionable ways with the distribution of opioids. The Post reports that these businesses pushed back, initially finding some success through lobbying the Department of Justice. However, they seemingly had their greatest success when Congress passed, and President Obama signed into law, changes to the DEA’s enforcement standards and procedures.

This legislation is the subject of the Marquette Law Review piece, authored by John Mulrooney and Katherine Legel. Mulrooney is an administrative law judge with the DEA. Legel, a graduate of Marquette Law School, was a judicial law clerk with the DEA. Of the 2016 law, they write, “If it had been the intent of Congress to completely eliminate the DEA’s ability to ever impose an immediate suspension on distributors or manufacturers, it would be difficult to conceive of a more effective vehicle for achieving that goal.” This and other aspects of the law review article are noted in the Post’s reporting. Student-editors who have been working on the article should feel gratified to see the piece playing such a prominent role in the ongoing efforts of journalists, policymakers, and academics to better understand the multitude of factors that may be contributing to the current opioid crisis.

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