What would you do?

Also: How a simple device could help reduce racial inequities for pregnant women [View in browser](    [❤️]( February 7, 2023 Hi CommonHealth reader, Imagine you’re a doctor. There’s a patient next to you, and you’re not sure what to do. But it’s not a medical quandary. It’s a legal one. What do you do? There’s a clear answer at hospitals in the Mass General Brigham system. MGB has a team of in-house lawyers, and one of their jobs is to staff a 24/7 legal hotline, so any clinician can get guidance. “Sometimes they need an answer in 0.2 seconds,” said Emma Melton, senior legal counsel at MGB, who staffs the hotline along with other “patient care” attorneys. “Sometimes we have a few minutes [or] a few hours to think through something.” When on-call, Melton answers questions through the night and weekend. She said July is a particularly busy month (when medical students become brand new doctors) and around the holidays volume ticks up too (since that’s a period when extra family time can exacerbate tensions). But sometimes, Melton said, clinicians just call for moral support. “Sometimes they aren’t clear about having a legal issue but say, ‘I'm in a pickle, I need some help.’ And so they call us,” she said. “It's about just being on their team, even if it’s not purely a legal question.” I spoke with Melton about the most common — and the most fascinating — questions she gets asked. We thought we’d present three hypothetical cases for you to weigh in on. Where do you think the law comes down? What is the ethical thing to do? Puzzle over them. Let us know your thoughts (just reply to this email). And, next week, we’ll share Melton’s legal advice in each case. Scenario #1: No place to go An elderly man no longer needs to be in an acute care hospital, but he does need the support of a rehabilitation facility. However, because of a history of violence, his medical team cannot find any facility that’s willing to take him, and his family is unable to provide the care he needs at home. What should the medical team do? Should they discharge this patient? Should they keep him in the hospital indefinitely? Something else? Scenario #2: Who decides for the fetus? A woman with substance use disorder is using drugs that are dangerous to the fetus throughout the pregnancy. She indicates to her medical team that she intends to continue using. Can her providers stop her from using drugs or do something else to protect the fetus? Scenario #3: Estranged family A woman loses consciousness in a car accident. Her health care proxy form is decades old. It says her husband should make medical decisions for her, but they’ve been estranged — although not divorced — for a long time. Who gets to make decisions about this woman’s medical care? What advice would you give the medical team about these three scenarios? Again, just reply to this email, and we’ll sum up your responses next week along with Melton’s answers. Bonus points if you can point to the legal principle behind the right answer. P.S. — A quick reminder that it’s almost Valentine’s Day, and you can support WBUR by buying flowers for your loved ones through our fundraiser. We'll deliver your gift nearly anywhere in New England. Learn more and place your [order here]( (my editor tried it and says the process is both smooth and quick). Gabrielle Emanuel Health reporter [Follow]( Support the news  This Week's Must Reads [State freezes admissions at Leominster nursing home after COVID outbreak and 2 deaths]( State officials said a total of 83 people tested positive in the outbreak, including almost half of the facility’s residents and 33 staff members. [Read more.]( [State freezes admissions at Leominster nursing home after COVID outbreak and 2 deaths]( State officials said a total of 83 people tested positive in the outbreak, including almost half of the facility’s residents and 33 staff members. [Read more.]( [Black women are more likely to get sick and die from pregnancy. A simple medical device could help]( High blood pressure is sometimes called the “silent killer” because it can suddenly rise to dangerous levels without causing pain or other symptoms. A program at Boston Medical Center sends pregnant patients home with blood pressure cuffs, and closely monitors their readings everyday — all to improve their health and reduce racial and ethnic disparities in pregnancy care. [Read more.]( [Black women are more likely to get sick and die from pregnancy. A simple medical device could help]( High blood pressure is sometimes called the “silent killer” because it can suddenly rise to dangerous levels without causing pain or other symptoms. A program at Boston Medical Center sends pregnant patients home with blood pressure cuffs, and closely monitors their readings everyday — all to improve their health and reduce racial and ethnic disparities in pregnancy care. [Read more.]( [Gas stove makers have a pollution solution. They're just not using it]( Gas utilities and cooking stove manufacturers knew for decades that burners could be made that emit less pollution in homes, but they chose not to. That may may be about to change. [Read more.]( [Gas stove makers have a pollution solution. They're just not using it]( Gas utilities and cooking stove manufacturers knew for decades that burners could be made that emit less pollution in homes, but they chose not to. That may may be about to change. [Read more.]( [Abortion legal hotline launches in Mass. but open to all]( The Reproductive Equity Now Foundation launched the hotline with the Massachusetts attorney general, the Women's Bar Foundation, the ACLU of Massachusetts and five big-name law firms offering pro-bono legal advice. [Read more.]( [Abortion legal hotline launches in Mass. but open to all]( The Reproductive Equity Now Foundation launched the hotline with the Massachusetts attorney general, the Women's Bar Foundation, the ACLU of Massachusetts and five big-name law firms offering pro-bono legal advice. [Read more.]( [This doctor wants to prescribe a cure for homelessness]( A growing hospital movement aims to improve health outcomes of homeless patients with what might be considered the ultimate preventive care: providing them with a home. [Read more.]( [This doctor wants to prescribe a cure for homelessness]( A growing hospital movement aims to improve health outcomes of homeless patients with what might be considered the ultimate preventive care: providing them with a home. [Read more.]( What We're Reading 📚 This week I read a new study, in[JAMA Pediatrics]( that brought yet another warning about screen time. These researchers — including some at Boston Children’s Hospital — followed kids for 10 years. They found that 12-month-olds who spent more time watching screens were more likely to have challenges at the age of 9, including issues with attention and poorer performance on executive function tests for things like emotional regulation and learning. The researchers write: “In short, increased screen time in infancy is associated with impairments in cognitive processes critical for health, academic achievement, and future work success.” They found the more screen time, the worse the outcome. There were no significant differences between demographic groups. However, the researchers are quick to warn that this association does not mean screen time is causing the issues. It could be a proxy for other things in the child’s life, such as the “quality of the parent-child interaction.” It's also worth noting that the study was conducted before the pandemic. It reminds me of [studies about how screen time shot up]( during the pandemic (at least for older kids) and makes me wonder how even more screen time during the pandemic will affect kids' attention and learning skills. "We're putting so much energy and work into pre-eclampsia, in the interest of not just better outcomes, but better outcomes specifically for the populations that have suffered from inequities." — Tina Yarrington, director of maternal-fetal medicine at Boston Medical Center, on the hospital's [effort to address the "root cause" of many racial inequities in maternal health](. ICYMI [Growing violence against health care workers prompts Mass. hospitals to adopt new codes of conduct]( Massachusetts hospitals reported 13,734 “abusive incidents” last year, a 28% increase from 2021. Most of the violent and verbal attacks came from patients and were leveled at health care workers. [Read more.]( [Growing violence against health care workers prompts Mass. hospitals to adopt new codes of conduct]( Massachusetts hospitals reported 13,734 “abusive incidents” last year, a 28% increase from 2021. Most of the violent and verbal attacks came from patients and were leveled at health care workers. [Read more.]( 🧠💥 Did you know...💥🧠 ...scientists have a new guess for why bears rub up against trees? It might be that it offers them a natural tick repellent. Researchers discovered that ticks seems to hate the tar that oozes out of beech trees. [Reading about this]( makes me want to try smearing beech tar on myself once summer comes. 😎 Forward to a friend. They can sign up [here](. 📣 Give us your feedback: newsletters@wbur.org 📧 Get more WBUR stories sent to your inbox. [Check out all of our newsletter offerings.]( Support the news     Want to change how you receive these emails? Stop getting this newsletter by [updating your preferences.](  I don't want to hear from WBUR anymore. Unsubscribe from all WBUR editorial newsletters [here.](  Interested in learning more about corporate sponsorship? [Click here.]( Copyright © 2022 WBUR-FM, All rights reserved.