MADISON, Wis. - In Wisconsin, the concept of "informed consent" means a doctor must give the patient the tools necessary to make an informed decision about their care. However, the state Legislature is considering changing that law, to let doctors decide which treatments or diagnoses patients should know about.

A doctor's failure to obtain informed consent is a form of malpractice, said Meg Gaines, a University of Wisconsin law professor, adding that such cases are very rare.

"Frankly, it doesn't happen that often in Wisconsin, and I think that's fine," she said. "That's not the point. The point is that we need to move forward on engaging patients in determinations about what should happen next."

Current law is based on having reasonably informed patients make the ultimate decision about what they want their doctor to do.

Gaines described a "reasonably informed patient" as "neither someone who says, 'I don't want to know anything, doc, just do what you gotta do' - which is sort of, probably unreasonably, not wanting to know - nor a patient who says, 'I need to know everything down to the microscopic level. I want to see all the tapes, all the results, I want to talk to all the physicians you had reading my diagnostic tests, I want, I want, I want ...' "

There were 117 cases filed alleging malpractice in Wisconsin in 2012. Gaines said that isn't many.

"If you are an insurance carrier for malpractice in the average state, you pay out 83 cents on every dollar you take in in premiums," Gaines said. "In Wisconsin, you pay out 45 cents."

Before taking away a patient's right to self-determination, Gaines said lawmakers should be taking more time to carefully consider such a fundamental revision.

"We seem to have driven right past that exit - or, at least, we seem to be driving right past that exit in this bill," she said, "and I hope that we will pull off at roadside assistance and get ourselves a Blue Ribbon Commission."

Supporters of the proposed change in the law said it addresses a malpractice problem, but Gaines said it's a problem that doesn't exist in Wisconsin. The State Assembly will discuss the bill Thursday.

The measures are AB-139 and SB-137.


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The Environmental Protection Agency this week banned a toxic chemical commonly used in dry cleaning and other consumer products.

Trichloroethylene and perchloroethylene have been used for decades and are known to affect the liver, brain, kidney and immune and nervous systems. Research shows dry-cleaning and laundry workers are at increased risk of dying from cancer.

Jennifer Orme-Zavaleta, former principal deputy assistant administrator for science at the EPA Office of Research and Development, said businesses will be required to use alternatives and employees will be safer at work, adding the changes also affect surrounding communities.

"If you happen to live near a dry-cleaning facility, you know there would be the potential for the ground to be contaminated and for these chemicals to get into the water supply," Orme-Zavaleta pointed out.

California has been ahead of the curve. In 2007, the state banned installations of new perchloroethylene dry-cleaning machines, required existing ones be shut down by 2010, and required a complete ban of use of the chemical by 2023.

Orme-Zavaleta noted many environmental statutes are aimed at cleaning up hazardous chemicals. While recent legislation has enabled the EPA to more effectively reduce exposures or prevent them from happening in the first place, she stressed the effort takes time and resources.

"The agency's been playing a lot of catch up," Orme-Zavaleta acknowledged. "They need to keep going, but they also need to be looking to the future, especially looking at some of the new chemicals coming into commerce."

According to the advocacy group Heal the Planet, the dry-cleaning industry uses hundreds of millions of gallons of solvents such as perchloroethylene every year, the chemical's airborne particles are difficult to detect in the air and can linger for weeks.


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Kentucky residents are being notified about their lead water pipes that could be posing a health danger. According to an EPA report, around 40,000 service lines in the Commonwealth contain lead, and earlier this year the agency announced a new rule requiring drinking water utilities in all states to identify and replace lead pipes within ten years.

Dr. Leah Werner, family physician and assistant professor at Oregon Health and Science University, said the federal change increases water sampling and transparency about lead between communities and local governments, and added that there are actions residents can take, too.

"People can also test their own water, and really the best way to do that is to look at your either your city government website, and beyond that, the government is mandated to help you with testing kits, but Home Depot and places like that also sell lead testing kits," she explained.

The mailed notices from utilities will confirm whether or not a home relies on lead water lines, or if the piping materials is unknown, and if any pipes need to be replaced.

Werner added that if a family is concerned that they and their children may be exposed to lead, it's important to visit a primary-care physician as soon as possible, who can also be a guide through the process of testing and treatment for lead exposure.

"Lead crosses the placenta, so that is really dooming a fetus before even being born, to the same sort of cognitive impairments and behavioral issues that children who are exposed to lead suffer," Werner continued.

According to the CDC, exposure to lead can reduce IQ in children and be a primary driver to learning disabilities and Attention Deficit/Hyperactivity Disorder, permanently damage the brain and nervous system, and cause speech and hearing problems.


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If your holiday shopping list is far from complete, consumer advocates in Nebraska hope you don't ignore warning signs of scams in the rush to buy gifts.

In a digital world, there are always new things to pay attention to.

Over the past few years, shoppers have been warned about avoiding gift card scams, or not falling prey to phony texts about a shipment delay.

Jina Ragland - associate state director of advocacy and outreach for AARP Nebraska - said the emergence of cryptocurrency in the online trading world presents another challenge, including during the holiday shopping crunch.

"Scammers and fraudsters are using the same types of scams that they've used in the past," said Ragland, "but they're now soliciting people to pay them through the cryptocurrency ATMs, using things such as bitcoins and that."

AARP says if you're directed to send someone money by converting cash to cryptocurrency at a convenience store kiosk, it's a scam.

As for other tips, experts note scammers can tamper with gift cards on store racks and steal the funds when the card is activated.

They say it's best to ask for a gift card sold behind the counter. They also advise regularly updating software on your electronic devices for additional fraud protection.

Ragland said if you get a call from someone initiating a scam about a purchase you never made, asking for a call-back number will quickly get their attention.

"Typically, you will find if you do ask for a call-back number, they're going to hang up on you immediately," said Ragland, "because they've not gotten what they need and they want it, and they know you're on to them. "

Overall, Ragland said a key thing to remember is, if you see an online ad for something that appears too good to be true in terms of price, it's usually a fishy deal.

Shoppers are also encouraged to take advantage of tracking information and other shipping supplier services, and to schedule deliveries for when you or someone you trust is present to receive them.