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C H R I S T O P H E R D O V A L , E S Q .
A S S I S T A N T P R O F E S S O R O F M A N A G E M E N TA N D M A R K E T I N G
R E G I N A L D F . L E W I S C O L L E G E O F B U S I N E S SV I R G I N I A S T A T E U N I V E R S I T Y
J . D . M . S . B . A .
Self-Determination in the Law
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C H R I S T O P H E R D O V A L , E S Q .
A S S I S T A N T P R O F E S S O R O F M A N A G E M E N TA N D M A R K E T I N G
R E G I N A L D F . L E W I S S C H O O L O F B U S I N E S SV I R G I N I A S T A T E U N I V E R S I T Y
J . D . M . S . B . A .
Thank you for having me
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C H R I S T O P H E R . D O V A L @ G M A I L . C O M
T W I T T E R : @ P R O F D O V A L
S K Y P E : C H R I S D O V A L
8 0 4 . 3 0 1 . 0 2 0 3
P I C S , T H O U G H T S A N D Q U E S T I O N S
S L I D E S A V A I L A B L E A T
C H R I S T O P H E R D O V A L . C O M
I Love Feedback!
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Sovereignty of StatesSelf-Determination in theLaw
Sovereignty &Secession Christiana
Pro se and Due Process
Identity and Licenses
Landlord and TenantLaw
Medical Malpractice
Abortion Assisted Suicide
Living Wills andDNR/PTO
The Direction of Our Talk
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Sovereignty of StatesSelf-Determination in theLaw
Sovereignty &Secession Christiana
Pro se and Due Process
Identity and Licenses
Landlord and TenantLaw
Medical Malpractice
Abortion Assisted Suicide
Living Wills andDNR/PTO
The Direction of Our Talk
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Sovereignty of States
1648 Peace of Westphalia(Nation/State Sovereignty)
1649 English Parliament overthrowsMonarchy
1792 French Revolution
1865 13th Amendment(Slavery)
1866 14th Amendment(Citizenship, Priv. and ImmunityCl., Due Process Cl., and Equal
Protection Cl.)
1869 15th Amendment(Right to Vote)
1920 19th Amendment (Right to Vote)
1933 21st Amendment(Anti-Prohibition)
1964 Civil Rights Act
(End of Segregation)
1971 26th Amendment
(18 Voting Age)
1990 Americans with Disabilities Act
2001-Present Same-sex Marriage
2008 Genetic InformationNondiscrimination Act (GINA)
2013 Prop 8 and DOMA
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State Sovereignty
To recognize an entity as a state is to acknowledgethat it has an international legal right of territorialintegrity (in turn that the land is not someone elses).
De Jure States An organization is recognized as having sovereignty over and
being the legitimate government of a territory over which theyhave no actual control.
De Facto Sovereignty over a territory, but lack international
recognition
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How do we start our own Nation?
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How do we start our own Nation?
http://www.youtube.com/watch?v=Vl4ufIrMtXg
Welcome to
Christiana, Denmark
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Step 1:
Are you eligible?
Step 2: Have you declaredindependence?
Do you have a definedterritory?
Do you have a permanentpopulation?
Do you have agovernment? Is it capable of interacting
with other nations?
Benefits
Can no longer be freelyattack to return to neithernation.
Prohibition of the use offorce under the U.N.
Charter.
State Sovereignty (Simple, but not Easy)
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Step 3:
Get recognized
Step 4:
Join the club
No cookie cutter approach. No Olympic invitation until
recognized.
United States has noofficial policy.
The decision to recognize astate is made by thepresident. based on U.S. national
interests.
Applyto the U.N.
Sample - Montenegro
Applyto the E.U. Criteria
Yes, you need to be inEurope currently
Sample - Montenegro
State Sovereignty (Simple, but not Easy)
http://www.un.org/en/ga/about/ropga/adms.shtmlhttp://www.securitycouncilreport.org/atf/cf/%7B65BFCF9B-6D27-4E9C-8CD3-CF6E4FF96FF9%7D/UNMembers%20S2006409.pdfhttp://europa.eu/about-eu/countries/joining-eu/index_en.htmhttp://ec.europa.eu/enlargement/policy/conditions-membership/index_en.htmhttp://www.consilium.europa.eu/uedocs/cms_data/docs/pressdata/en/misc/107351.pdfhttp://www.consilium.europa.eu/uedocs/cms_data/docs/pressdata/en/misc/107351.pdfhttp://ec.europa.eu/enlargement/policy/conditions-membership/index_en.htmhttp://europa.eu/about-eu/countries/joining-eu/index_en.htmhttp://www.securitycouncilreport.org/atf/cf/%7B65BFCF9B-6D27-4E9C-8CD3-CF6E4FF96FF9%7D/UNMembers%20S2006409.pdfhttp://www.un.org/en/ga/about/ropga/adms.shtml7/28/2019 Self-determination in the Law
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Pro se and Due Process
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ANYONE KNOW THEIR
MIRANDA RIGHTS?
How about in the Legal
Process?
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. . . T H E P E R S O N I N C U S T O D Y M U S T , P R I O R T O I N T E R R O G A T I O N , B EC L E A R L Y I N F O R M E D T H A T H E / S H E
H A S T H E R I G H T T O R E M A I N S I L E N T , A N D
T H A T A N Y T H I N G T H E P E R S O N S A Y S W I L L B E U S E D A G A I N S TT H A T P E R S O N I N C O U R T ;
T H E P E R S O N M U S T B E C L E A R L Y I N F O R M E D T H A T H E / S H E H A ST H E R I G H T T O C O N S U L T W I T H A N A T T O R N E Y A N D
T O H A V E T H A T A T T O R N E Y P R E S E N T D U R I N GQ U E S T I O N I N G , A N D
T H A T , I F H E / S H E I S I N D I G E N T , A N A T T O R N E Y W I L L B EP R O V I D E D A T N O C O S T T O R E P R E S E N T H I M / H E R .
From Miranda v. Arizona
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Criminal Case Civil Case
Only if the state is
trying to deprive you ofyour liberty.
or for a fee you canafford.
Court fees?
Sometimes reduced orwaived
Youre on your own.
Judicial economy?
Free Attorney?! Court Fees?!
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In case you
weresleeping
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How does the Law intersect
with Medicine?
G O V E R N I N G P R I N C I P L E S ?
H O W D O W E R E C O N C I L E F A C T S / S C I E N C EW I T H S U B J E C T I V E V A L U E S ?
A B O R T I O N ?
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W E C A N N O T S U S T A I N 9B I L L I O N P E O P L E O NO R G A N I C F A R M I N G .
O R G A N I C F A R M I N G C A NO N L Y S U S T A I N 2 / 3 O F T H E
C U R R E N T W O R L D SP O P U L A T I O N
Do we have time for GMOs?
The Man who Saved a Billion Lives
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WHAT COMPARISON CAN THERE REALLY BE, IN
POINT OF SEVERITY, BETWEEN CONSIGNING AMAN TO THE SHORT PANG OF A RAPID DEATH,AND IMMURING HIM IN A LIVING TOMB?
JOHN STUART MILL
SPEECH IN FAVOR OF CAPITAL PUNISHMENT
Capital Punishmentv.
State-Sponsored Murder
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Cruzan v. Director,Mo. Dept. of
Health (1990) If state law requirements are met, aperson may state her wishes aboutterminating medical treatment orappoint an agent to make the decisionsfor her.
Where the persons wishes are not clearlyexpressed, the state may assert aninterest in favor of preserving life
and preventing the withdrawal oftreatment.
ConstitutionalRight tomake healthcaredecisions,
including theright to refusemedicaltreatment
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Physician-A
ssisted
Suicid
e
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Illegal Legal
Prohibit by law
39 States
Prohibit by commonlaw AL, DC, MA, and WV
Unclear on Legality NV, NC, UT, and WY
Montana*
Oregon Vermont
Washington
*via court ruling
Physician-Assisted Suicide
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Legal Legal
Montana
Oregon Vermont
Washington
Medical Marijuana
Alaska Arizona California
Colorado Connecticut District of Columbia Delaware Hawaii Maine Maryland
Massachusetts Michigan Montana Nevada New Hampshire New Mexico Rhode Island
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Legal Legal
Montana
Oregon Vermont
Washington
Gay Marriage
California Connecticut
District of Columbia Delaware Iowa Maine Maryland
Massachusetts Minnesota New Hampshire New York Rhode Island
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Illegal Legal
Prohibit by legislation 39 States
Prohibit by commonlaw AL, DC, MA, and WV
Unclear on Legality NV, NC, UT, and WY
Montana*
Oregon Vermont
Washington
*via court ruling
Physician-Assisted Suicide
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Physician-Assisted Suicide Legal Breakdown
Aiding Suicide Criminal Homicide Manslaughter Manslaughter 2nd Degree Felony Felony Class C
Imprisonment 1-15 years
Fines $30k, 50k
Aiding attempted Suicide Imprisonment
1-7 years
Fines $14k
Mens Rea - Guilty Mind Purposefully Knowingly and willfully Intentionally Deliberately
Actus reus Guilty Act Causes Aids Prescribes Provides the means
Advises Encourages Advertises, offers or holds
himself out as offering Coerces Solicits!
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Physician-Assisted Suicide Legal Breakdown
Aiding Suicide Manslaughter Manslaughter 2nd Degree Felony Felony Class C Imprisonment
1-15 years Fines
$30k, 50k
Aiding attempted Suicide Imprisonment
1-7 years Fines
$14k
Mens Rea - Guilty Mind Purposefully Knowingly and willfully Intentionally Deliberately
Actus reus Guilty Act Causes Aids Prescribes Provides the means
Advises Encourages Advertises, offers or holds
himself out as offering Coerces Solicits!
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Requires any health care institution receiving Federalfunds (but not individual doctors) to do the following:
1. Give you at the time ofadmission a written summary of: your health care decision-making
rights. Different per state
the facility's policies with respect torecognizing advance directives.
2. Ask you if you have an advancedirective, and document that fact
in your medical record if you do. Patients responsibility to deliver copy
3. Educate their staff andcommunity about advance
directives.
4. Never discriminateagainst patients based on
whether or not they have
an advance directive. Thus, it is against the law forthem to require either that youhave or not have an advancedirective.
Patient Self-Determination Act
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ROOTED IN CONTRACTLAW?AGENCY LAW?
Healthcare Directives, Living Willsand
The Power of Attorney
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BTW
Is there a CoffeeMachine aroundhere?
This is Yale, right?
I know youve gotfancy coffee here.
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BTW
Boom!
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BTW
Weve got an Agency!
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Elements of Agency Level of Strength
Weve got anAgency!
Assent
Benefit
Control
Simple Power of
Attorney-Ends upon incapacity
Durable Power ofAttorney-Survives incapacity-Ends upon death
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SEEKS TO PRECOMMIT
PHYSICIANS AND OTHERS TOCERTAIN BEHAVIOR, TO IMPOSE
ON THEM A RESPONSIBILITY TOTREAT ACCORDING TO AN
INDIVIDUALS PREVIOUSINSTRUCTIONS.
Advance Directives
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Types of Instruments Purpose
Instructional
Directives
Proxy Directives
Specifies either generally orvia examples how to betreated in an end-of-lifesituation.
Designates an agent to makehealth care decisions for the
patient.
Advance Directives? Issues?
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Types of Instruments Purpose
Instructional
Directives
Proxy Directives
Hybrid
Specifies either generally orvia examples how to betreated in an end-of-lifesituation.
Designates an agent to makehealth care decisions for the
patient.
Hybrid
Advance Directives
A G id i h E U
http://www.americanbar.org/content/dam/aba/administrative/law_aging/2011/2011_aging_hcdec_univhcpaform_4_2012_v2.authcheckdam.pdfhttp://www.americanbar.org/content/dam/aba/administrative/law_aging/2011/2011_aging_hcdec_univhcpaform_4_2012_v2.authcheckdam.pdfhttp://www.americanbar.org/content/dam/aba/administrative/law_aging/2011/2011_aging_hcdec_univhcpaform_4_2012_v2.authcheckdam.pdfhttp://www.americanbar.org/content/dam/aba/administrative/law_aging/2011/2011_aging_hcdec_univhcpaform_4_2012_v2.authcheckdam.pdfhttp://www.americanbar.org/content/dam/aba/administrative/law_aging/2011/2011_aging_hcdec_univhcpaform_4_2012_v2.authcheckdam.pdfhttp://www.americanbar.org/content/dam/aba/administrative/law_aging/2011/2011_aging_hcdec_univhcpaform_4_2012_v2.authcheckdam.pdfhttp://www.americanbar.org/content/dam/aba/administrative/law_aging/2011/2011_aging_hcdec_univhcpaform_4_2012_v2.authcheckdam.pdf7/28/2019 Self-determination in the Law
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A Guide with an Easy-to-Use,Legal Form for All Adults
http://www.americanbar.org/content/dam/aba/administrative/law_aging/2011/2011_aging_hcdec_univhcpaform_4_2012_v2.authcheckdam.pdfhttp://www.americanbar.org/content/dam/aba/administrative/law_aging/2011/2011_aging_hcdec_univhcpaform_4_2012_v2.authcheckdam.pdfhttp://www.americanbar.org/content/dam/aba/administrative/law_aging/2011/2011_aging_hcdec_univhcpaform_4_2012_v2.authcheckdam.pdfhttp://www.americanbar.org/content/dam/aba/administrative/law_aging/2011/2011_aging_hcdec_univhcpaform_4_2012_v2.authcheckdam.pdfhttp://www.americanbar.org/content/dam/aba/administrative/law_aging/2011/2011_aging_hcdec_univhcpaform_4_2012_v2.authcheckdam.pdfhttp://www.americanbar.org/content/dam/aba/administrative/law_aging/2011/2011_aging_hcdec_univhcpaform_4_2012_v2.authcheckdam.pdfhttp://www.americanbar.org/content/dam/aba/administrative/law_aging/2011/2011_aging_hcdec_univhcpaform_4_2012_v2.authcheckdam.pdfhttp://www.americanbar.org/content/dam/aba/administrative/law_aging/2011/2011_aging_hcdec_univhcpaform_4_2012_v2.authcheckdam.pdfhttp://www.americanbar.org/content/dam/aba/administrative/law_aging/2011/2011_aging_hcdec_univhcpaform_4_2012_v2.authcheckdam.pdfhttp://www.americanbar.org/content/dam/aba/administrative/law_aging/2011/2011_aging_hcdec_univhcpaform_4_2012_v2.authcheckdam.pdfhttp://www.americanbar.org/content/dam/aba/administrative/law_aging/2011/2011_aging_hcdec_univhcpaform_4_2012_v2.authcheckdam.pdf7/28/2019 Self-determination in the Law
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Please Turn Over (P.T.O.)
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Do Not Resuscitate (DNR.)
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Do Not attemptResuscitation(DNAR)
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The No Code? AND?
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Color Codes Doctor Codes
Blue Patient needs resuscitation
Red Fire
Yellow Bomb Threat
Purple Child Abduction
Grey Combative person No Weapons
Silver Combative person Weapons
Triage S*** hit the fan!
Paging Doctor __X__.
StorkWoman in labor
Firestone/Pyro, third floor
Fire third floor
Strong/Armstrong
Combative person
Learn the Lingo - Hospital Codes
Hospital Association of Southern California suggestions, but personal to every hospital
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Issues
Medical order writtenby a doctor
Instructing health careproviders not to do
cardiopulmonaryresuscitation (CPR) ifbreathing stops or ifthe heart stops beating.
Medical, not Legal Doctors note
Not like other directives Crossing state lines Inconsistent laws
Likelihood of good? Where are your papers?
Tattoos no good unless EMTs will likely save you.
Or at least treat othersymptoms
DNR Order
The Idea
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Historically
Body not considered
property Not disposable by Will
Not owned bydescendant's estate or
by family Left within jurisdiction
of Church
Disposition of the Body
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Today
Courts exercise abenevolent discretion to
carry out the wishes of thedeceased.
Provided these wishes do not
conflict reasonably with theliving.
If violent or suspicious death,law mandates an autopsy.
Disposition of the Body
Not likely going to get
Buried with yourbelongings?
Forbid Funeral services?
Extravagant send off?
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P E R M I T S A N Y P E R S O N T O G I V E H E R B O D Y T O A N Y H O S P I T A L , P H Y S I C I A N , M E D I C A L S C H O O L , O R B O D Y B A N K
F O R R E S E A R C H O R T R A N S P L A N T A T I O N .
A L S O P E R M I T S A G I F T O F A B O D Y , O R P A R T S T H E R E O F .T O A N Y S P E C I F I E D I N D I V I D U A L F O R T H E R A P Y O R T R A N S P L A N T A T I O N N E E D E D B Y T H E I N D I V I D U A L
* D E S P I T E L E G I S L A T I O N , T H E U N I T E D S T A T E S H A S B E E N I N A C O N S I S T E N T S T A T E N E E D F O R T R A N S P L A N T S
Uniform Anatomical Gift Act of
1968
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Fin.Comments, Concerns, Curses?
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PREMISE 1:MOST MEDICAL TREATMENTS
INVOLVE SOME RISK
Medical Malpractice and
Informed Consent
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PREMISE 1:MOST MEDICAL TREATMENTS
INVOLVE SOME RISK
Medical Malpractice and
Informed Consent
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