Can NH physicians order an end to parental rights for refusal of treatment or evaluation? If you would like a concrete example, consider parents of a healthy infant who was born premature and ill but is no longer in any apparent need of medical treatment. The hospital staff asks the parents to drive hours to get evaluations done, which the parents no longer want to submit to. Often the medical staff recommend unnecessary or dangerous procedures and treatments which are denied. If the parents simply deny the request to bring the infant child to these apparently unnecessary evaluations that would obviously deprive the hospital of money and not make friends of the staff. Can the physicians declare the parents unfit with any legal backing?
No To declare that a parent is &quot;unfit&quot; in the US requires at least a decision by a government agency (often called &quot;child protective services&quot; or &quot;child welfare&quot; depending on the state) usually confirmed by a judge. Medical testimony may be persuasive, but neither doctors nor hospitals may make such determinations.
The court clerk was right. A judge is not supposed to interact with a party (at least not in the absence of the adversary) except during court hearings for which the adversary was notified and given an opportunity to attend. Also, there is no need for you to prove the mere fact that you went to court. That in itself is either inconsequential or palpable from the hearing transcripts. When you file in court papers such as a motion or a response to a motion, you may --and should-- bring an extra copy for the clerk to stamp it. That a clerk does with no objections. The stamp reflects the date on which you file your document(s). That stamp incidentally evidences that you or someone on your behalf went to court but, again, that sole fact is inconsequential. There is no such thing as "motion to appeal". A litigant may initiate an appeal, or appellate process, once the judge has decided a case in its entirety or in part. If the ruling to be appealed does not close the case, the upper court might refuse to review the issue(s) appealed until the whole case has been decided (that refusal is known as denial of the appellant's leave to appeal). Your description nowhere indicates that the judge has already made any rulings or that there have been any hearings on your matter. Your mention of prior motions suggests that you should gain acquaintance with the Texas Rules of Civil Procedure and of Appellate Procedure. Those rules cover several aspects of litigation, including motion practice, the allowed methods of service, and the requirements to file an appeal in upper courts.
The Fifth Amendment would not apply, because nothing in the testimony would incriminate the doctor. Indeed nothing would be at all likely to incriminate the President either, it is not a crime to be unable to carry out Presidential duties. It is likely in such a case that the President would waive confidentiality. In that case the doctor could testify freely. If the President insisted on confidentiality, and attempted to prevent the doctor from testifying to Congress, there would be a conflict between the power of Congress to compel testimony, in this case on what is clearly a vital national issue within the scope of the needs of Congress, and traditional doctor-patient confidentiality, let alone the requirements of HIPAA. I am not sure how this conflict would be resolved. There might be an emergency application to the Supreme Court, but the SC does not usually do very well with truly urgent issues. The Pentagon Papers case and Bush V. Gore indicate some of the problems that can arise. If the doctor was prevented from testifying, that might incline members of congress to think the testimony would not be favorable to the President, and thus tend to suggest that they should not approve the President resuming or continuing his or her powers and duties. But that is rather speculative. The 25th has never been invoked, and the detailed procedure that would be followed if it were is not very clear. I am not aware of any similar situation in which medical testimony has been demanded to deal with an urgent issue, but the patient has attempted to block it. I think this case must be considered to be undecided until it actually arises and a court rules.
She can't force him, but the court can. This would be a court ordered paternity test. If one parent can't give blood for some reason they could do something else like a cheek swab.
Such sad and tragic circumstances, my sympathy to all involved. General I do not know the specifics of English law as it applies but I believe it is similar enough to New South Wales, Australia that the general overview that follows is not likely to be far wrong. Before a court intervenes there has to be a dispute and someone with standing must bring an action to the court. We can surmise that a dispute arose about the best medical treatment for the child between the child's parents and the child's medical professionals - if there was unanimity there would have been no legal proceedings. Ultimately this is an issue of the welfare of the child. Medical professionals are under a legal obligation to report issues of child welfare to the relevant authorities. In the UK, the government authority responsible for child welfare is the Department of Education. We can presume that they intervened in accordance with their policies and procedures and their understanding of the law and the dispute could not be resolved. It is likely the DoE that brought the matter to the courts or the parent's disputing a DoE decision. The court will decide such issues in the best interest of the child. In deciding what that is, they will consider all the evidence including the parent's wishes, the child's wishes (not relevant in this case but it can be for older children), other relatives, medical opinion etc. They will also consider what the law is, including precedent and make their decision. If you read the linked article about the high court trial the judge is quoted as saying: “It is with the heaviest of hearts but with complete conviction for Charlie’s best interests that I find it is in Charlie’s best interests that I accede to these applications and rule that GOSH may lawfully withdraw all treatment save for palliative care to permit Charlie to die with dignity.” “I dare say that medical science may benefit objectively from the experiment, but experimentation cannot be in Charlie’s best interests unless there is a prospect of benefit for him.” “Charlie’s parents have sadly but bravely acknowledged and accepted that the quality of life that Charlie has at present is not worth sustaining, for he can only breathe through a ventilator, and although they believe that he has a sleep/wake cycle and can recognise them and react to them when they are close, they realise that he cannot go on as he is lying in bed, unable to move, fed through a tube, breathing through a machine.” “Understandably, Charlie’s parents had grasped that possibility, they have done all they could possibly have done, they have very publicly raised funds. What parents would not do the same? But I have to say, having heard the evidence, that this case has never been about affordability, but about whether there is anything to be done for Charlie.” “But if Charlie’s damaged brain function cannot be improved, as all agree, then how can he be any better off than he is now, which is a condition that his parents believe should not be sustained?” This decision was reviewed by the European Human Rights Court who “endorsed in substance the approach” taken by the British courts and declared “the decision is final”. Is it &quot;symptomatic of a Single-Payer healthcare system&quot; Probably not. Almost universally, child welfare cases are decided on the &quot;best interests of the child&quot;. This judge in this case within this legal and cultural system decided as he did - and I do not doubt that it was a difficult and emotional task. Change the judge, change the case, change the law and change the culture and you may change the decision but, then again, maybe not. Perhaps in a place with a different culture towards health care, the medical practitioners would not have formed the opinion that the experimental treatment was not in the best interest of their patient and there would have been no dispute that required government intervention. Legal basis Governments can pass laws that impact the people in their jurisdiction. The UK government has passed laws that allow them to interfere in the normal relationship of parental authority. The UK government is not unique - all countries have such laws. Further, the UK government controls who enters and leaves their borders and in what circumstances. Did the NHS (or the hospital) take custody of the child away from the parents? Almost certainly not - this was not a custody battle. Or does the NHS get to decide upon the welfare of its patients once they are in the system? Of course. Every medical professional/hospital/clinic everywhere in the world has a legal and moral responsibility to provide treatment in the best interests of their patients. They will get sued if they don't. Why were the parents not able to take Charlie away on their own recognizance, like (presumably) adults can refuse treatment and leave the hospital? Because an adult can decide for themselves, a child cannot. Other people have responsibility for deciding for the child and when, as here, people with overlapping responsibilities (parents and medical professionals) have divergent views, the government intervenes through executive or judicial action.
The health insurance contract should set forth what is and is not covered in detail (in addition, there would be a short summary version). They probably don't have to provide procedure codes that are covered or not covered because no such one to one correspondence exists because the language of the insurance contract is controlling and does not exactly correspond to procedure codes. For example, one of the basic eligibility questions is whether a procedure is medically necessary. A procedure may be medically necessary for one person, but not for another, and usually a denial based upon medical necessity is subject to appeal to other medical professionals engaged by the insurance company. Unless the insurance contract provides that an EOB must contain procedure codes, it probably doesn't have an affirmative obligation to do so, because there is no general principle of law that would require them to disclose their internal classification of services provided outside of a litigation context. And, in a litigation context, you probably could obtain procedure codes in discovery from the insurance company, as the code assigned to a procedure on an EOB would almost surely not be privileged or a legally protected secret. It may very well be that the company has an in house set of procedures for certain common diagnosis codes that are routinely allowed or are flagged for review by an insurance company bureaucrat. But, that would ordinarily be considered something of a trade secret of the company and is not a statement of what is or is not allowed under the actual health insurance contract. However, the privilege against disclosing the information in that context would flow from trade secret law and not from the fact that they are PHI. I don't agree that PHI is the correct reason for failing to disclose that information (unless some case law of which I am not aware has interpreted it differently). The federal law definition of PHI is at 45 CFR 160.103: Protected health information means individually identifiable health information: (1) Except as provided in paragraph (2) of this definition, that is: (i) Transmitted by electronic media; (ii) Maintained in electronic media; or (iii) Transmitted or maintained in any other form or medium. (2) Protected health information excludes individually identifiable health information: (i) In education records covered by the Family Educational Rights and Privacy Act, as amended, 20 U.S.C. 1232g; (ii) In records described at 20 U.S.C. 1232g(a)(4)(B)(iv); (iii) In employment records held by a covered entity in its role as employer; and (iv) Regarding a person who has been deceased for more than 50 years. The cross reference to 20 U.S.c. 1232g(a)(4)(B)(iv) reads as follows: (iv) records on a student who is eighteen years of age or older, or is attending an institution of postsecondary education, which are made or maintained by a physician, psychiatrist, psychologist, or other recognized professional or paraprofessional acting in his professional or paraprofessional capacity, or assisting in that capacity, and which are made, maintained, or used only in connection with the provision of treatment to the student, and are not available to anyone other than persons providing such treatment, except that such records can be personally reviewed by a physician or other appropriate professional of the student’s choice. In short, it is B.S. that you are being given an illegitimate reason for not complying with your request, but it is probably still within the company's rights for other legitimate reasons to deny your request.
But even then, to my understanding, a contract can't prohibit a party from seeking legal remedies. You are mistaken. A contract settling a bona fide dispute regarding people's legal rights can mutually (or unilaterally for that matter) release or waive their legal rights. In fact, a waiver or release of rights is routinely a part of a settlement agreement. Hundreds of thousands, if not millions, of such agreements are entered into every year and they are almost always enforced. Sometimes, but not always, a settlement agreement will also call for a dismissal of a case with prejudice, which (roughly) means a dismissal that prohibits refiling a case involving the same subject matter.
The husband of the mother of a child is presumed to be that child's parent until that presumption is disestablished. In New York State, when a child is born to a married mother, a court may decline to consider DNA evidence when it is not in the best interests of the child to do so. In substance (although not exactly from a legal perspective), a failure to promptly contest the paternity of a child of a married mother gives rise to a de facto adoption. Article 5 of the New York Family Court Act in its definitions section, § 512, makes clear that it applies only to children born out of wedlock (and it too has an equitable paternity term at § 532). So, the statutory deadline in Article 5 allowing a child with no legally determined father to have a determination made at any time before the child turns age twenty-one does not apply to this case. Instead, this case is governed by New York Family Court Act, Article 4. New York Family Court Act § 418(a), which governs paternity cases where a child is born during a marriage provides that: (a) The court, on its own motion or motion of any party, when paternity is contested, shall order the mother, the child and the alleged father to submit to one or more genetic marker or DNA marker tests of a type generally acknowledged as reliable by an accreditation body designated by the secretary of the federal department of health and human services and performed by a laboratory approved by such an accreditation body and by the commissioner of health or by a duly qualified physician to aid in the determination of whether the alleged father is or is not the father of the child. No such test shall be ordered, however, upon a written finding by the court that it is not in the best interests of the child on the basis of res judicata, equitable estoppel or the presumption of legitimacy of a child born to a married woman. The record or report of the results of any such genetic marker or DNA test shall be received in evidence, pursuant to subdivision (e) of rule forty-five hundred eighteen of the civil practice law and rules where no timely objection in writing has been made thereto. Any order pursuant to this section shall state in plain language that the results of such test shall be admitted into evidence, pursuant to rule forty-five hundred eighteen of the civil practice law and rules absent timely objections thereto and that if such timely objections are not made, they shall be deemed waived and shall not be heard by the court. If the record or report of results of any such genetic marker or DNA test or tests indicate at least a ninety-five percent probability of paternity, the admission of such record or report shall create a rebuttable presumption of paternity, and, if unrebutted, shall establish the paternity of and liability for the support of a child pursuant to this article and article five of this act. If DNA evidence is considered, the biological father will be determined to be the father, but if it is not considered, the husband will continue to be the legal father. A leading case exploring when the best interests of the child test prevails over DNA evidence from New York is In the Matter of Shondel J., v. Mark D., 853 N.E.2d 610 (N.Y. July 6, 2006). In a key passage, it states: Equitable estoppel is gender neutral. In Matter of Sharon GG. v Duane HH. (63 2 859 [1984], affg 95 AD2d 466 [3d Dept 1983]), we affirmed an order of the Appellate Division dismissing a paternity petition in which a mother sought to compel her husband to submit to a blood test as a means of challenging his paternity. We agreed with the Appellate Division that the mother should be estopped. As that court pointed out, the mother expressed no question about her child's paternity until some two and a half years after the child's birth. She had held the child out as her husband's, accepted his support for the child while she and her husband lived together and after they separated, and permitted her husband and child to form strong ties together. Estoppel may also preclude a man who claims to be a child's biological father from asserting his paternity when he acquiesced in the establishment of a strong parent-child bond between the child and another man. The rationale is that the child would be harmed by a determination that someone else is the biological father. For example, in Purificati v Paricos (154 AD2d 360 [2d Dept 1989]), a boy's biological father who did not seek to establish his paternity until more than three years after the child's birth, and who acquiesced as a relationship flourished between the boy and his mother's former husband, was estopped from claiming paternity. The courts "impose equitable estoppel to protect the status interests of a child in an already recognized and operative parent-child relationship" ( In re Baby Boy C., , 84 NY2d 91, 102 n [1994]). Finally, the Appellate Division has repeatedly concluded that a man who has held himself out to be the father of a child, so that a parent-child relationship developed between the two, may be estopped from denying paternity.2 Where a child justifiably relies on the representations of a man that he is her father with the result that she will be harmed by the man's denial of paternity, the man may be estopped from asserting that denial.3 . . . Given the statute recognizing paternity by estoppel, a man who harbors doubts about his biological paternity of a child has a choice to make. He may either put the doubts aside and initiate a parental relationship with the child, or insist on a scientific test of paternity before initiating a parental relationship. A possible result of the first option is paternity by estoppel; the other course creates the risk of damage to the relationship with the woman. It is not an easy choice, but at times, the law intersects with the province of personal relationships and some strain is inevitable. This should not be allowed to distract the Family Court from its principal purpose in paternity and support proceedings -- to serve the best interests of the child. This continues to be good law. See, e.g. In the Matter of Thomas T. v. Luba R., 148 A.D.3d 912 (March 15, 2017) (paternity by estoppel established when child at age four did not know biological father's name and had established a strong father-child-like bond with mother's currently partner citing Shondel). Under the circumstances, if any of the three parties: the mother, the husband, or the biological father, sought to prevent consideration of DNA evidence after ten to fifteen years of marriage during which paternity was not denied, it is very likely that the Court would agree and not change the legal paternity of the child. In this case, the biological father would not gain legal visitation rights and would not owe child support, and neither the husband nor the mother would lose their presumed parent status, nor would they be entitled to child support. If the husband, mother and biological father mutually agreed otherwise, the paternity by estoppel argument might be overcome and any issue of support would be governed by the mutual agreement (although a guardian ad litem for the child might be appointed sua sponte by the Court and have standing to object to the agreement on behalf of the child notwithstanding the mutual agreement of the other three parties). This would terminate husband's status as a parent and entitle biological father to visitation. But, otherwise paternity by estoppel would prevail. Incidentally, this statute and case law position is constitutional. The U.S. Supreme Court has held that a man who conceives a child with a married woman does not have a due process right in establishing his paternity of the child, so any right that the biological father may have arises from statute and the common law, rather than from the U.S. Constitution. Michael H. v. Gerald D. (U.S. 1989).