Hostname: page-component-586b7cd67f-dlnhk Total loading time: 0 Render date: 2024-11-28T16:57:06.746Z Has data issue: false hasContentIssue false

Expert Testimony by Persons Trained in Ethical Reasoning: The Case of Andrew Sawatzky

Published online by Cambridge University Press:  01 January 2021

Extract

In February 1999, I received a call from a lawyer at Hill Abra Dewar stating that she had instructions to retain my services as an expert witness in the case of Sawatzky v. Riverview Health Centre. She was representing the Manitoba League of Persons with Disabilities which had intervenor status.

In Canada the admission of expert testimony depends upon the application of four criteria outlined in R. v. Mohan by Justice Sopinka. These criteria are: (a) relevance; (b) necessity in assisting the trier of fact, (c) the absence of any exclusionary rule; and (d) a properly qualified expert. The lawyer believed that I could provide the court with relevant, reliable ethics testimony about surrogate decision-making and about medical futility-information that likely would be outside the experience and knowledge of the trier of fact.

Type
Article
Copyright
Copyright © American Society of Law, Medicine and Ethics 2000

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

R. v. Mohan [1994], 2 S.C.R. 9 at 20.Google Scholar
Mishkin, D.B., “Proffering Bioethicists as Experts,” The Judges' Journal 56 (1997): 5053.Google Scholar
Pellegrino, E.D. and Sharpe, V.A., “Medical Ethics in the Courtroom: The Need for Scrutiny,” Perspectives in Biology and Medicine, 32 (1989): 547564.CrossRefGoogle Scholar
McAllen, P.G. and Delgado, R., “Moral Experts in the Courtroom,” Hastings Center Report 14, no. 1 (1984): 2734.CrossRefGoogle Scholar
“Children and the Elderly: Who Should Decide?” in Baylis, F. et al., eds., Health Care Ethics in Canada (Toronto: Harcourt Brace, 1995): At 279.Google Scholar
Rubin, S., When Doctors Say No: The Battleground of Medical Futility (Bloomington, Indiana: University Press; 1998): at 47.Google Scholar
Feldman, D., Health and Medicine in the Jewish Tradition (New York: Crossroads Publishing; 1986); “Standards and Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiac Care: Ethical Considerations in Resuscitation” JAMA, 268 (1992): 2282–88; Youngner, S.J. “Who Defines Futility?” JAMA, 260 (1988): 2094.Google Scholar
Youngner, , id. at 2094–95.Google Scholar
Tomlinson, T.L. and Brody, H., “Ethics and Communication in Do-Not-Resuscitate Orders,” N. Engl. J. Med., 318 (1988): 4346; Youngner, , “Who Defines Futility?” id. at 2094.CrossRefGoogle Scholar
Brett, A.S. and McCullough, L.B., “When Patients Request Specific Interventions: Defining the Limits of the Physician's Obligation,” N. Engl. J. Med., 315 (1986): 1347–51.CrossRefGoogle Scholar
Schneiderman, L.J. Jecker, N.S. and Jonsen, A.R., “Medical Futility: Its Meaning and Ethical Implications,” Annals of Internal Medicine 15 (1990): 949–54.CrossRefGoogle Scholar
Barber v. Superior Court of California, 147 Cal. App. 3d 106, 1017–18, 195 Cal. Rptr. 484 (1983).Google Scholar
Schneiderman, Jecker, and Jonsen, , supra note 12, at 950; Schneiderman, L.J. and Jecker, N.S., Wrong Medicine: Doctors, Patients, and Futile Treatment (Baltimore: Johns Hopkins University Press, 1995), 159; Thomasma, D.C., “Beyond Medical Paternalism and Patient Autonomy: A Model of Physician Conscience for the Physician-Patient Relationship,” Annals of Internal Medicine 98 (1983): 243–48.Google Scholar
Lo, B. and Jonsen, A.R., “Clinical Decisions to Limit Treatment,” Annals of Internal Medicine 93 (1980): 764–68; and Paris, J. J. Crone, R.K., and Reardon, F.E., “Physicians' Refusal of Requested Treatment: The Case of Baby L,” N. Engl. J. Med., 322 (1990): 1012–15.Google Scholar
Wolf, S., quoted in Belkin, L., “As Family Protests, Hospital Seeks An End to Woman's Life Support,” New York Times (1991): A1, A16.Google Scholar
Article 29-B, Statute 413-A, The State of New York Public Health Law, 1988; The New York Task Force on Life and the Law, Do Not Resuscitate Orders. 2nd ed. New York, 1986.Google Scholar
Jecker, N.S. and Pearlman, R.A., “Medical Futility: Who Decides?” Archives of Internal Medicine 152 (1992): 11401144; 1984 Amendments to the Child Abuse Prevention and Treatment Act, Public Law 98–457, 1984; Schneiderman, Jecker, , and Jonsen, , supra note 12, at 950; Schneiderman, and Jecker, , supra note 14, 17.CrossRefGoogle Scholar
Schneiderman, Jecker, , and Jonsen, , supra note 12, at 952–53; Schneiderman, and Jecker, , supra note 14, at 17.Google Scholar
Lantos, J.D. et al., “The Illusion of Futility in Clinical Practice,” American Journal of Medicine 87 (1989): 8184; and Lo, B. and Jonsen, A.R. “Clinical Decisions to Limit Treatment,” 764.CrossRefGoogle Scholar
Lo, and Jonsen, , supra note 15, at 764.Google Scholar
Bedell, S.E. et al., “Survival after Cardiopulmonary Resuscitation in the Hospital,” N. Engl. J. Med., 309 (1983): 569–76; Blackhall, L.J., “Must We Always Use CPR?” N. Engl. J. Med., 317 (1987): 1218–84.CrossRefGoogle Scholar
Taffet, G.E. Teasdale, T.A., and Luchi, R.J., “In-Hospital Cardiopulmonary Resuscitation,” JAMA, 260 (1988): 2069–72.CrossRefGoogle Scholar
Perkins, H.S., “Ethics at the End of Life: Practical Principles for Making Resuscitation Decisions,” Journal of General Internal Medicine 1 (1986): 170–76; Ruark, J.E. and Raffin, T.A. “Initiating and Withdrawing Life Support: Principles and Practice in Adult Medicine,” N. Engl. J. Med. 318 (1988): 25–30.CrossRefGoogle Scholar
Jecker, N.S. and Pearlman, R.A., “Medical Futility;” Schneiderman, Jecker, , and Jonsen, , supra note 12, at 951–52; Youngner, , supra note 8, at 2094.Google Scholar
“Joint Statement on Resuscitative Intervention (Update 1995),” Canadian Medical Association Journal 153 (1995): 1652A-C.Google Scholar
“MMA Takes Position on Futile Therapy.” Inter-Com (November 1997): 6.Google Scholar
Rubin, S., When Doctors Say No: The Battleground of Medical Futility, (Bloomington, Indiana: University Press; 1998): at 9.Google Scholar
Baylis, F., “Resuscitation of the Terminally Ill: A Response to Buckman and Senn,” Canadian Medical Association Journal 141 (1989): 1043.Google Scholar
Benjamin, M., Splitting the Difference: Compromise and Integrity in Ethics and Politics, (Kansas: University Press of Kansas, 1990).Google Scholar