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Health lawyers and policymakers cannot always see the same shadows of the laws that are visible to health care providers, and sometimes those shadows have penumbras and emanations that are not visible to those outside of a narrow medical practice. Sometimes those shadows, whether real or imagined, cause doctors to act inconsistently with the intent of the law, and inconsistently with the requirements of good medical practice. Doctors may misread or misunderstand a law. Still, if the law as misread or misunderstood actually affects medical practice, we should not be blind to the fact of the misunderstanding. Listen to doctors' criticism of the law skeptically, Professor Johnson says, and we will know how to create better, more effective laws to serve the public's health. The move from the recognition of "brain death" to the original living will and "Right to Die" statutes, to the more sophisticated advance directive statutes that recognized durable powers of attorney, to the Patient Self-Determination Act; and the development of pain relief statutes, physician assisted death statutes, the Uniform Health Care Decisions Act, and the new California Right-to-Know End-of-Life Options Act of 2008, have all been powered, in great part, by doctors' complaints about incentives created by the effects of then-current end-of-life law. Doctors have misunderstood much of this legislation, sometimes willfully, and they have ignored other parts of this law. Still, the law has created increasingly appropriate incentives by listening to the complaints of those doctors-even when those complaints are not really justified.

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Saint Louis University Law Journal



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End-of-Life Care, Health Law, Public Health



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